David A. Halperin, M. D.
Cults continue to present a dilemma for the families of cult members and an area of concern for the mental health professional. While a few professions have started to work in this area, the experience of the Cult Hotline and Clinic of the Jewish Board of Family Services and the Cult Information and Treatment program of the Westchester Jewish Community Services indicates that the demand for services far exceeds the number of professionals with a background in this area. This article details particular issues that this problem area intensifies and defines some useful training approaches to help the mental health professional seeking to be of service to this population.
There has been increasing recognition that cult affiliation presents more than a simple question of religious affiliation and orientation. The very intensity of feelings on the part of the families of cult members and the problem of working with ex-cult members have led to the creation of cult information centers within broader community-based mental health programs. The question arises as to what, if any, specialized training is required by those mental health professionals who attempt to work within this multi-dimensional context. This article attempts to deal with this issue, recognizing that the entire question of training within this area is as new as the programs that are being created. It reflects the experience gained in working within programs sponsored by the Westchester Jewish Community Services and the Cult Information and Treatment Program Hotline and Clinic of the Jewish Board of Family and Children’s Services of New York.
Relationship to Paraprofessionals
In training mental health professionals to work within a cult information and/or rehabilitation program, certain distinctive issues must be faced. Of primary importance is the fact that the mental healthy professional who attempts to work within this field must recognize that in many respects he is a Johnny-come-lately to this area of concern. In a manner quite comparable to the area of drug rehabilitation and narcotics abuse, the field has been preempted by a corps of paraprofessionals with their own claims to expertise and legitimacy. In a recent article, Maleson (1981) commented about the difficulties experienced by the mental health professionals who work within a field where all therapeutic efforts will be shadowed by the activities of this extensive paraprofessional network, as well as the activities of a variety of religious leaders of more mainstream persuasions.
Thus, training for a cult-centered program must help mental health professionals deal with the reality that in this area many people do not consider them to possess unique, or even necessary, professional skills. Training must help the mental health professional to establish the legitimacy of his efforts.
As a first step, professionals must gather together a body of knowledge about the plethora of religious and quasi-religious groups. Training must help professionals deal with the fact that as they attempt to communicate with a variety of workers their credentials may be questioned by those who either have or claim to have greater experience than the mental health professional with his more therapeutically based training. Moreover, a training program must prepare mental health professionals to deal with the fact that families will compare their therapeutic activity with that of “deprogrammers,” who promise instant redemption from a cult; a very difficult act to follow. This potentially competing network presents a challenge to one’s professionalism that must be considered during training, and especially during supervision. On the other hand, since it permits one to be comfortably in contact with a wide variety of religious leaders, ex-cult members, etc. (all of whom lay claim to a specialized expertise), one is given the opportunity for rewarding community outreach and involvement.
Dealing with Different Populations
In creating a training program, it is of cardinal importance to recognize that two different populations – with different needs and demands placed on professionals – are served within a cult-centered program. On the one hand, there are families, i.e., parents and spouses, who are distressed because a family member has joined a cult. Their needs, feelings, and the demands they place on the therapeutic setting are quite different from the other potential population served, i.e., the converts. Experience indicates that approximately 85% of visits to any program will be from parents wanting to discuss the problems of their children (Lightman, Note 1; Markowitz, Note 2). Thus, the major work performed within a cult-centered program will inevitably involve working with families whose children are currently within a cult. Indeed, a distinguishing aspect of this work is that the appearance of the identified patient (as opposed to the families) is a therapeutic event.
Let us consider the family whose child has (or, in some cases, children have) recently become affiliated with a cult. Their child’s entry is initially, at the very lease, a profoundly disturbing event. The parents are anguished. What does their child’s cult affiliation mean? What does it say about them? About their efforts at parenting? Has their child been brainwashed? How have they failed? And beyond any narcissistic concerns, the parents are legitimately concerned about their child’s future and about the controls (external and/or self-imposed) that may be exercised over their child.. To them, it is clearly an emergency, and remains so for long afterwards. Thus, a cult-centered program must expect to deal with parents who are in extremis and who continue to see their child as being in extremis.
In developing approaches to these families, a cult-centered program must recognize the parental expectations that are potentially denied and the parental hurt that is experienced. With some of these families, it may be quite easy for the mental health professional to recognize certain pathological modes of interaction. But mental health professionals must also recognize that despite the possibility that cult affiliation may play a role in effecting separation from a pathological familial structure, the child has chosen a cure that is potentially much more destructive than the disease. It is very difficult for mental health professionals to accept that the parents’ concerns for their children are not simply the product of injured narcissism, even in the case of demanding, occasionally histrionic, and conceivably over-invested families. This parental response reflects the parental realization that cult affiliation is not just simply a matter of religious choice, but rather a decision by an often uninformed and unformed individual that will profoundly direct and limit all future growth. Intense countertransference reactions on the part of the mental health professional in working with these pressured and pressuring, demanding and occasionally angry individuals in neither surprising nor unexpected.
Countertransference issues. The consideration of countertransference issues is the basis of much of the training that mental health professionals undergo, especially within the fields of dynamically oriented individual and group psychotherapy (Halperin, 1981). Work with the families within the cult-centered program may elicit strong countertransference response on many levels. Mention has been made above of the mental health professional’s withdrawal and passivity in response to the pressure exerted by the families of cult members. Overidentification with the cult member is another countertransference response of particular importance. On one level, the therapist overidentifies with the cult member and begins to regard cult affiliation as a not totally unreasonable mode of separating from what the professional experiences as an overintrusive and controlling family. On another level, many cults present themselves as vestiges of a more joyous and nostalgia-filled era: the sixties. Mental health professionals are not immune to nostalgia. It is very easy for the mental health professional to adopt a tolerant attitude towards groups which superficially preach a holistic, communalistic life style. This overidentification with late adolescents who have chosen to pursue “spirituality” – who have opted out of the “rat race” – becomes a very real issue in working with families who may indeed not have been ideal parents. After all, aren’t these parents just like the professionals’ own – parents who had opposed their wanderings out to San Francisco? Thus, a kind of belated Beatlemania becomes an issue which a meaningful training program must help the mental health professional explore in relation to his own overidentification with the cult member or in terms of his willingness to dismiss the bizarre manifestations of cult activity as just another example of a young person doing his own thing.
Training may speed up this process by helping the professional to recognize that the actual life of a cult member is hardly one of spiritual contemplation, but rather one of exploitation and envelopment. Likewise, mental health professionals who are often too keenly aware of the limitations of their art may become self-deprecatory and lend an exaggerated respect for the “cures” obtained through the sacrifice of individual autonomy by unorthodox religious groups. This may become a particularly acute issue in relationship to children who were severely dysfunctional prior to cult entry and whose parents may now deal with their children’s problems exclusively as a result of brainwashing or other cult-imposed deprivations. The mental health professional who acquiesces in cult affiliation because it provides a species of institutionalization would hardly do so if this degree of personal deprivation were imposed under more orthodox auspices.
Other countertransference issues arise when families initially present their problems as a change in religious affiliation. A mental health professional may experience the families as representative of organized religion and respond towards them according to his own feelings toward his own religious background. It is important for the mental health professional to develop some awareness of his own attitudes in this area. It is very easy to overidentify with children against their families, if the sometimes glib assertions about the emptiness of mainstream religious experiences are readily accepted. Yet, if the need for intense and transcendent religious experience is too readily dismissed as pathological, it makes it very difficult for the professional to develop the basis for a therapeutic alliance with the cult member.
Thus, a training program should help the mental health professional develop an awareness of the intense and complex countertransference responses that are elicited in working with the families of cult members. This can be accomplished primarily through group supervision. In addition, a meaningful training program must help the mental health professional develop a real familiarity with the various cults, especially their recruitment approaches (a particular focus of parental anger) and the group processes which are so significant a factor in maintaining the individual within the cult. Above all, the mental health professional must develop an understanding of that complex interweaving of individual needs, group pressures, and theology that provide for continued cult adhesion. Although this awareness will help the professional in his work with the ex-cult member, it is of particular importance in helping the families of cult members maintain a meaningful level of communication with the cult members themselves. The families can obtain some measure of relief as they begin to appreciate that cult membership plays a role within the individual’s psychic economy and that to deal with it simply as the product of brainwashing will not be constructive over the long haul.
Treatment approaches Mental health professionals must also develop a familiarity with the treatment approaches that may be used in working with families of cult members and the members themselves. There has been an overemphasis on involuntary deprogramming as a unique treatment modality. In reality, much therapeutic activity involves working with grief-stricken families whose children may scarcely be accessible on any level. Moreover, deprogramming is hardly a panacea and may be scarcely indicated when the cult member’s entire adult life has been bound up in fealty to a particular group. In this context, valuable work has been done with families of cult members in a variety of self-help and rehabilitation groups. Moreover, group approaches must be developed to help the siblings of cult members to communicate with their sibs. This article is not an appropriate forum to discuss the problems experienced in working with self-help or other groups; nonetheless, any meaningful training program should help to sensitize the professional to the problems that will be experienced in working within this modality. As can be imagined, the role of the professional in a self-help group is hardly that of the authoritative group leader. Nonetheless, he becomes the focus of the intense dependency needs that are projected onto him by the group members. Supervision can be particularly important in helping the beginning professional to work within such group settings, especially because the processes within the group may parallel those within the cults themselves. Both groups, for example, demand magic from the group leader. In this setting, however, the role of the leader is to demystify himself.
Contrary to expectations, most cult-centered programs have done relatively little work with the cult members (current or former) themselves. In many regards, the problems faced in working with current/former cult members are comparable to those experienced in working with drug users or abusers. In both cases, the “illness” provides certain symptomatic relief and those most concerned are often not the identified patient. Furthermore, in both situations there is an extensive nonprofessional treatment network. Mental health professionals need to know about the community resources that are available and to develop an awareness of their own feelings about these resources. Above all, the mental health professional, who is committed to promoting individual autonomy, may find it difficult to appreciate that some charismatic mainstream religious leaders can provide positive growth experiences, that there is a meaningful choice between the authoritative mainstream religious leader and the totalitarian cult leader.
In working with the individual cult member, the therapist must recognize that the identified patient may not necessarily be a candidate for intensive psychoanalytic approaches. Perhaps the most important task for therapy with cult members is to help them integrate the cult experience into their lives. The role of the therapist is to help individuals put this period of intense regression into the past and begin their lives anew. In this context, direct and empathetic support may be of greater value than encouraging regression, even if it is in the service of the ego. Nevertheless, a confrontational attitude within the context of therapy is not productive. Many cult members have had a sufficiency of experiences of self-denigration and self-doubt within the cult. They need support and a recognition of their own abilities. And, in many cases, by focusing on the nonpathological aspects of the cult experience, cult members may be able to discover skills they developed while in the cult.
Relatively few ex-cult members appear to be interested in long-term psychoanalytically oriented treatment. The reasons for their resistance may be manifold. But to this writer at least, the process of psychodynamically oriented psychotherapy, because it involves both the experience of anger and the experience of separation from significant figures, may result in affects that are too painful for the ex-cult member to experience or to use constructively. This explains, perhaps, why both cult members and their families tend to view the period of cult involvement as an aberration. Although this attitude need not be accepted blindly, here, as elsewhere, the patient’s defenses should be respected.
Thus, the framework for individual therapy with former cult members is one of short-term, reality-oriented interventions. Despite the presence of other pathology and the temptation towards a more uncovering mode of treatment, the focus should be on helping the ex-cult member become more comfortable in situations of separation (while in the cult, they have rarely had the experience of aloneness) and to develop a degree of comfort in asserting themselves (they have frequently been in contexts where decision-making responsibilities were very limited). Thus, training should help the therapist deal with the pre-entry pathology while recognizing that the cult experience has frequently exaggerated difficulties in the area of separation and decision-making. And finally, the nonmedical therapist should work within a framework in which psychiatric consultation is readily available. Some ex-cult members will obviously have more severe pathology, pathology that predates their entry into the cult and that requires psychiatric treatment.
- Lightman, M. The Cult Clinic: An approach to families in crisis. Paper presented at the National Conference of Jewish Communal Services, Denver, 1979.
- Markowitz, A. Personal communication, 1981.
Halperin, D. Issues in the supervision of group psychotherapy: Countertransference and the group supervisor’s agenda. Group, 1981, 5, 24-33
Maleson, F. G. Dilemmas in the evaluation and management of religious cultists. American Journal of Psychiatry, 1981, 138, 925-929.
David Halperin, M.D., author of Religion, Sect, and Cult (Boston: John Wright, 1983), is an Assistant Clinical Professor of Psychiatry at Mount Sinai School of Medicine of the City University of New York and a Consulting Psychiatrist to the Cult Hotline and Treatment Program of the Jewish Board of Family and Children’s Services and the Cult Information and Treatment Program of the Westchester Jewish Community Services.