Psychotherapy Networker Caught in the crossfire

Caught in the Crossfire
1995 Mar/Apr
By Katy Butler

A fierce public debate has therapists on the defensive (recovered memory).

On a cool, spring day last April, I sat with other reporters in a courtroom in the heart of northern California's wine country watching a family's private agony play itself out on the public stage. On the witness stand was Holly Ramona, a 24-year-old psychology graduate student, her curled, shoulder-length hair pulled back off her round young face by an Alice-in-Wonderland band. Facing her from the end of a long wooden counsel table was her father, Gary, a former $500,000-a-year vice president of sales and marketing for the Robert Mondavi winery a somber 50-year-old man in a conservative suit, with thinning, carefully brushed dark brown hair.

She had accused him of incest. He had sued her therapists.

Holly Ramona had gone into therapy as a bulimic and depressed 19-year-old. Her therapist, Marche Isabella, had inaccurately told Holly's mother before therapy even began that 70 to 80 percent of bulimics had been sexually abused. After four months of garden-variety therapy that focused on unremarkable family issues, Holly had started, hesitantly and equivocally, to report "memory flashes": her father stroking her inner thigh, his head between her legs, a flash of flying sheets, a struggle, pain in her vagina, him groaning above her, his smell, and her own frightened face. Within weeks, she related these memories to her therapist and her mother, Stephanie, who immediately wanted to confront her husband and file for divorce. In the family panic that followed, Isabella persuaded Holly's mother to wait a couple of weeks and let her daughter do the confronting. Then, in a hurried move that Isabella thought would certify the truth of Holly's memories, she and psychiatrist Richard Rose interviewed the unsure young woman under the influence of sodium amytal, the so-called "truth serum." Fifteen hours later, in a windowless office at Western Medical Center in Anaheim, California, Holly confronted her father in the presence of her mother and Isabella.

Gary Ramona denied that he had molested Holly, but in the aftermath, he lost his marriage, his job and his relationship with all three of his daughters. The next year, he sued Holly's therapists, Isabella and Rose, saying that they had implanted false memories of incest through the use of sodium amytal, phony statistics and suggestion. By the time the trial began, father and daughter had not spoken directly to each other for more than three years.

"My father doesn't seem to get the point," Holly Ramona said from the witness stand, testifying on behalf of her therapists, while her mother and two sisters listened. "No matter how much I say it, he still insists that I'm not reporting these events to him. I wouldn't be here if there was a question in my mind. I know my father molested me."

Later, her father's attorney handed her some Father's Day cards she had affectionately signed. "And this is the man you said you never wanted to hug?" he asked. "There are times now I would give anything to have a regular hug from my father, just a regular father-daughter hug," she replied, her voice breaking. "But I thought he would take it the wrong way." The judge called a recess and Gary Ramona rushed from the room. As the press cameras clicked, Holly Ramona left the witness stand, walked past her two former therapists to her mother and grandmother, and burst into tears. The case Gary Ramona versus Marche Isabella, M.F.C.C. and Richard Rose, M.D. was technically an $8 million malpractice suit. But only technically. It took place in April, National Child Abuse Awareness Month, and even in the courtroom, a scattering of people wore commemorative blue ribbons. Women who said they were incest survivors sometimes clustered on one side of the room, behind the two therapists and near Holly Ramona's mother and her friends. And on the opposite side of the room, behind Gary Ramona, sometimes sat tight-lipped, gray-haired men, members of the False Memory Syndrome Foundation, who all said they had been falsely accused of abuse. It sometimes felt as though the high-ceilinged Victorian room could barely contain the anger, fear and doubt of the trial's spectators, much less that of the Ramona family.

The split in the room reflected a national ideological war based on gender and generation. In the 1980s, hundreds of thousands of women had revealed to friends, therapists, 12-step groups and TV talk shows that they had been sexually abused as children. And, for the first time in history, they had, by and large, been believed.

In 1985, 22 percent of those polled across the country by the Los Angeles Times said they'd been sexually abused before the age of 18 the equivalent, on a national scale, of 38 million people.

Nearly 800,000 women bought The Courage to Heal, a self-help book based on interviews with more than 100 survivors of sexual abuse. At least 800 children sued their parents and others under laws passed in the late 1980s extending statutes of limitation regarding sexual abuse.

Little attention was paid at that time to the feelings of the parents neither the innocent nor the guilty and by 1992, there were enough parents protesting their innocence to form a support and advocacy group for accused parents with an impressive scientific advisory board. By the time the trial began, 8,000 accused parents had contacted the False Memory Syndrome Foundation (FMSF) (see sidebar), and 2,500 had joined. They said their adult children had entered therapy without memories of abuse, and had been led to manufacture not "uncover" them.

They said they had tried to meet with their daughters' and sons' therapists to tell their side of the story and had been refused. They said their grown children wouldn't see them, or had written vague, accusatory letters, or had summoned them to meetings in their therapists' offices where they'd been read a list of charges indictments, really without a chance to reply. They condemned The Courage to Heal, the incest survivors' self-help "bible," especially one sentence that reads, "If you are unable to remember any specific instances . . . but still have a feeling that something abusive happened to you, it probably did." The parents, and some research psychologists, said that belief in the validity of long-forgotten memories of childhood molestation recovered in therapy was like belief in memories of past lives or space-alien visitations.

And so the Ramona trial became more than a struggle between a father and daughter over who had been injured and who would be believed. To some incest survivors, it was part of a backlash, a symptom of a culture's denial, an attempt by a wealthy and powerful man to silence his daughter after she had barely begun to speak. To some feminists, it was yet another skirmish in a decade-long conflict much like the date-rape trial of William Kennedy Smith and the confirmation hearing of Supreme Court Justice Clarence Thomas over accountability for many kinds of male-on-female violation. To most reporters and much of the general public, the trial was about reckless therapists breaking up a family. And for therapists everywhere, it was the start of a harsh new era.

PRIVATE THERAPY, THAT entrepreneurial, ad-hoc, reimbursable and quasi-scientific venture, had operated for decades with few constraints. Once therapists got their licenses, they had been free to practice pretty much as they saw fit, ignoring research if it didn't interest them, often working without supervision, trying whatever seemed to work, going their own ways. Nobody seemed to mind much as long as they avoided egregious malpractice. Psychoanalysis, cognitive-behavioral therapy, family systems, Gestalt weekends at Esalen, primal therapy, marriage counseling, Milton Erickson's cryptic directives that clients climb Squaw Mountain or grow African violets had all come (and some had gone) without too much fuss, mainly because the public hadn't paid much attention.

But now, psychotherapy has woven itself deeply into the fabric of American life. There are more than 250,000 accredited therapists in the United States, and one study shows that one in three Americans has visited one. And as therapy moves from the sidelines into the spotlight, it is being triangulated into the intense cultural war over child sexual abuse. What takes place in the therapy room that once-private, secular confessional has come under unprecedented scientific, legal, legislative and media scrutiny. And the backlash over incest therapy is only part of a larger crisis of confidence in the values of psychotherapy as a whole.

On May 13, 1994, a divided and ambivalent jury decided that Holly Ramona's memories were false and that her therapists had reinforced but not implanted them. "They were too quick to take the ball and run with it," said the jury foreman, Thomas Dudum, a fabric salesman. "[But] I want to make it clear that we did not believe, as Gary indicates, that these therapists gave Holly a wonder drug and implanted these memories. It was an uneasy decision, and there were a lot of unanswered questions." They awarded Gary Ramona $475,000, far less than the $8 million he had asked for, far less even than the $ 1 million he had spent on legal fees.

The verdict and the damages awarded, though smaller than expected, were a major victory for other parents in Gary Ramona's position. The jury had ruled 9-3 that Holly's memories were false and that her therapists had committed malpractice. A judge, for the first time in recent legal history, had allowed a non-patient to sue somebody else's therapist for something other than a suicide, murder or wrongful death. Even though Marche Isabella had never called herself a "memory therapist" and the first four months of her clinical notes hardly mentioned either sex or memory, The New York Times, which interviewed Gary Ramona but not his daughter or her mother, described Holly's treatment as "memory therapy... a technique some call healing, some call hokum." And this was only the beginning.

In April, not long after the Ramona trial began, a woman named Kimberly Mark filed suit in San Luis Obispo, California against five therapists and Laura Davis, coauthor of The Courage to Heal and author of The Courage to Heal Workbook. Mark blamed the workbook and her former therapists for wrongly convincing her that she had been sexually abused. (The suit against Davis and a similar one filed soon afterward by a woman in Sacramento, were dismissed last September on First Amendment grounds.)

The same spring, two angry fathers, members of the FMSF who said they had been falsely accused, picketed the offices of their daughters' therapists in Oregon and Washington State. Other parents filed scores of challenges to clinical licenses, and hundreds of malpractice insurance claims. In Salem, Oregon, a gynecologist challenged the license of sex therapist and social worker Wendy Maltz, arguing that an article she had written in 1990 for a journal titled Medical Aspects of Human Sexuality could suggest false incest diagnoses. (The complaint was dismissed in April 1994.)

In Wisconsin, aggrieved and well-connected parents from the FMSF unsuccessfully lobbied the chancellor of the University of Wisconsin, protesting its co-sponsorship of the 10-year-old Midwest Conference on Child Sexual Abuse and Incest. They wanted a "retractor" to share the stage with keynote speaker Marilyn Van Derbur, a former Miss America, whose memories of childhood sexual abuse later corroborated by a sister had not surfaced until she was 24.

This past November, the highly regarded New York Review of Books spent two issues showcasing retired Berkeley English professor ( and perennial Freud critic) Frederick Crews's laudatory reviews of three books on "false memory" cognitive psychologist Elizabeth Loftus's The Myth of Repressed Memory, sociologist (and FMSF advisory board member) Richard Ofshe's Making Monsters, and accused father Mark Pendergrast's Victims of Memory. The review vilified incest therapists, turned the "incest recovery movement" into the "recovered memory movement," and promoted the claim that an epidemic of sex abuse hysteria had infected as many as a million suggestible adult women.

In Boston that same fall, a group of incest survivors called "Silent No Longer" picketed a speech by Loftus, who is also a FMSF advisory board member.

By December 1994, 300 women and men had "recanted" accusations of parental sexual abuse and had contacted the FMSF; about 150 of them had also sued former therapists. An executive for one of the nation's largest malpractice insurance brokers said his company alone received 200 claims and suits from parents and recanters. "The litigation is going geometric and the amount of money involved is staggering," said Brandt Caudill, a malpractice lawyer in Orange County, California, who is defending therapists in 26 similar lawsuits and 3 complaints before licensing boards.

This past December, two more therapists were held legally responsible not for "implanting" memories, but for believing them. Just before Christmas, a Pittsburgh, Pennsylvania, jury ruled against psychiatrist Judith Cohen for not investigating beliefs of abuse that teenager Nicole Althaus had held before she even entered therapy. In 1991, Nicole, then 15, had told a teacher and a social worker that her parents had sexually abused her, and she was placed in foster care. She was sent to Cohen, who diagnosed Nicole as suffering from Post-Traumatic Stress Disorder.

At trial, Cohen testified that her job was to treat Nicole, not investigate her. She said she had never believed Nicole's most outrageous claims that her grandmother flew on a broom and that she'd been raped before diners in a crowded restaurant. But after Nicole recanted all her accusations in 1992, she and her parents argued that Nicole had clung to false beliefs because Cohen hadn't challenged them. "She [Cohen] saw the diagnosis as a certainty, and did not check out anything else," said Nicole's father, Richard Althaus, an FMSF member. The jury agreed and awarded $272,000 to Richard, his wife, Cheryl, and 19-year-old Nicole, who is now a college student.

Just before Christmas, a jury in Dallas, Texas, awarded Laverne and Edward Khatain of Seattle $350,000, finding that psychiatrist Wayne Jones of Richardson, Texas, had slandered them to their granddaughters and damaged their family relationships. Jones had seen the Khatains' daughter over a period of years in therapy, for treatment of repeated self-injury and attempted suicide. After she reported severe sexual abuse by her father, Jones held a family session at which he and his client told the Khatains' granddaughters, one of whom was planning her wedding, of the alleged abuse. The Khatains sued in 1992, arguing that Jones had repeated their daughter's accusations to their granddaughters as if they were fact. Some months later, Jones's client recanted her charges. When asked if he was a specialist in sexual abuse cases, Jones said, "No. And I'm sexual-abuse phobic now."

Christopher Barden, a Minneapolis psychologist and attorney closely allied with some parents in the FMSF, says that more slander suits like the Khatains's are likely to be filed in states that effectively bar malpractice claims from parents and other nonpatients. "Every therapist who ever held a confrontation with someone else in the room, whether it was a nurse or another family member, is now potentially liable for slander or defamation," he says. "These therapists have always felt they had no obligation whatsoever to investigate these claims [of sexual abuse ], and that's morally indefensible," he continues. "You just can't assume everything you hear in a psychotherapy session is true and you can't go spouting it to the world. The fact that you can be sued shouldn't surprise anyone."

In January of this year, Barden, who was appointed in 1993 to the Minnesota State Board of Psychology, was putting the final touches on a strict "Truth and Responsibility in Mental Health Practices Act," which he hopes to get passed by the new Congress and at least 21 state legislatures. It has already been introduced in the New Hampshire legislature.

Among other provisions, it would require therapists to certify to private and public health insurance programs that their therapy is "safe and effective" and provide citations from scientific journals to prove it. Therapy that cannot meet these standards, Barden says, should be classified as "experimental" and ineligible for reimbursement, including the "memory retrieval therapy" that, in an earlier funding proposal circulated to FMSF parents, he made clear was his most immediate target.

"There's an enormous amount of health care fraud going on. These therapists have violated the Nuremberg Code: you should not experiment on patients without their permission," says Barden. Responding to critics who have described the false memory movement as a backlash against incest survivors, Barden says, "This is not a backlash against a political movement. It's a backlash against therapists who violate the ethical rules of their own profession. It will prevent the next wave of dangerous fads. We had lobotomies, rolfing, primal screaming, and now recovered memory therapy. If my law is not passed we will see this kind of thing happening again, with devastating impacts."

Why are a relatively small group of accused parents so close to setting the clinical agenda for millions of genuine abuse survivors and eclipsing public awareness of the more than 130,000 children who are newly sexually victimized each year? Why have therapists accused of suggestive therapy drawn more public attention than therapists accused of sexually abusing clients? And why are therapists only yesterday the substitute sages of a secular and splintered society suddenly its scapegoats and trolls?

AT THE DEMOCRATIC NATIONAL convention in the summer of 1992, Al Gore described his young son's nearly fatal car accident and positively alluded to family counseling. Later, in his acceptance speech, presidential nominee Bill Clinton, sounding like the speaker at an Adult Children of Alcoholics meeting, told the nation how he'd stood up one night to his alcoholic stepfather. Then the balloons came down, and everyone started dancing to Fleetwood Mac.

It's been downhill ever since.

In the winter of 1992, television viewers and newspaper readers all over the country learned that Boston psychiatrist Margaret Bean-Bayog had been sued by the family of the late Paul Lozano, a former patient and Harvard medical student who had killed himself with an overdose of cocaine. Among his possessions were copies of Bean-Bayog's graphic, handwritten sexual fantasies and tapes of her reading him childhood bedtime stories. Bean-Bayog denied she'd had a sexual relationship with Lozano, but ultimately surrendered her medical license.

That same year, Michael Ventura and James Hillman published We've Had a Hundred Years of Psychotherapy and the World's Getting Worse, arguing that too many people were talking to their therapists instead of building a meaningful political and community life. In 1993, Time magazine writer and art critic Robert Hughes published the widely praised The Culture of Complaint, about "a polity obsessed with therapies and filled with distrust of formal politics... an infantilized culture of complaint in which Big Daddy is always to blame and the expansion of rights goes on without the other half of citizenship attachment to duties and obligations."

In June of that year, Woody Allen, the poster child of psychoanalysis and a veteran of decades of the best (and best-publicized) therapy money could buy, was called "self-absorbed, untrustworthy, and insensitive" by a Manhattan judge. On the witness stand, the parade of therapists who had treated the family sounded nearly as bad as Allen himself, with their wishy-washy avoidance of moral language and plain speech. One called Allen's affair with 19-year-old Soon-Yi Previn, "a mistake, given the circumstances." Was Woody Allen "evil," a lawyer asked Susan Coates, the therapist of Allen's son Satchel. She replied, "I would say that this is someone whose judgement is very impaired."

In January 1994, people wondered whether victimhood had become an excuse for practically anything when two separate Los Angeles juries, deeply divided by gender, declared themselves deadlocked in the cases of Lyle and Erik Menendez, who had shotgunned their mother and father to death as they sat in front of their television set in Beverly Hills. Defense attorneys argued that the Menendez's father had sexually abused them, and they were afraid he'd kill them if they revealed it.

Everywhere you looked, therapists seemed to be failing to fulfill one implied promise or another. Therapy, the critics said, was promoting a culture of victimization and reproach, overselling itself as an art, pretending to be a science, and providing no moral vision while usurping the authority of moral leaders. It was like the moment Dorothy pulls back the curtain on the Great and Powerful Wizard of Oz and discovers only a human being. Then, in the November elections, those who went to the polls especially angry and economically threatened white men voted the Democrats, and therapeutic values, out. A feminine culture of talk and reproach was eclipsed by the masculine politics of rage, the end result of two decades in which real wages for men declined 11 percent. Clinton the Comforter lost the spotlight to Gingrich the Cruel the man who talked about orphanages and had taken a legal pad to the hospital to discuss his impending divorce while his then-wife lay recovering from cancer surgery. As GOP advisor Don Sipple told Newsweek shortly after the election, the Democrats had lost partly because they came across as "therapists" while the Republicans came across as "disciplinarians."

"Therapy has been helpful, but it oversold itself, just as the right-wing disciplinarians are overselling themselves now," says Stephanie Coontz, author of The Way We Never Were and professor of history at Evergreen State University in Washington State. "Neither of them has the real solution. You can't solve the kinds of problems our society is facing by jailing or by analyzing everyone in sight."

In the past two decades, Coontz says, almost all social compacts, between men and women, bosses and workers, children and parents, have shifted like sand beneath our feet, creating free-floating anxiety, loneliness and rage. The rules of all the games have changed: the meaning of terms like "good wife" and "good husband"; the expectation of a lifetime job (or marriage); the promise of upward mobility and a decent public education for one's children. Definitions of seduction, date rape and sexual harassment are shifting, and so is the meaning of "time" and "place" in a society turning more to the Internet than to the clock tower in the town square. Neighborhoods, churches, unions, communities and extended families that once buffered people against such vicissitudes have crumbled. The more the social fabric tears, the more people turn to therapists to pick up the pieces. But therapists couldn't or didn't do much to reknit the larger fabric. "The labor-management bargain and the male-female bargain a whole fragile morality that depended on female and parental altruism to counterbalance economic self-aggrandizement has broken down," says Coontz. "And therapy has set itself up for failure by holding out to people the promise that you could solve this by better communication."

To family therapist Bill Doherty, author of a forthcoming critique of therapists' attempt to remain morally neutral called Soul-Searching, therapy's failure is worse than Coontz imagines. Therapists, he says, are not just bystanders at the cultural car wreck, they have helped create the problem by emphasizing individualistic self-expression over family and community obligation.

In 1990, shortly after his son went off to college for the first time, Doherty went to a university student counseling center and talked to psychology interns about the importance of family relationships. An intern asked him, "What about the situation where the family is so toxic that the best thing is for the student to have a complete severing?" Doherty agreed that he'd seen a handful of families like that, and asked the young woman what percentage of her caseload was made up of them. Seventy percent, she said. "I had just sent my son off to college," says Doherty. "And I was terrified that he would get into trouble and see someone like this woman. Therapists are perceived as splitting up families, and there's more to that than backlash."

David Spiegel, a psychiatrist and professor at Stanford Medical School specializing in trauma and dissociation, sees something else at work. "I think there's a backlash against all therapy, not just bad therapy. It's a little worrisome," Spiegel says. "The backlash against therapy is a backlash against the idea that anybody can be the victim of cruel circumstances. So victims of trauma are stigmatized, and people who try to help them get stigmatized too."

IT WAS IN THIS CULTURAL CLI-mate a diffuse disenchantment with psychotherapy, distress over the breakup of families, and a widespread weariness with trauma victims that the False Memory Syndrome Foundation emerged, throwing all of these issues into the harshest possible light. Therapists, the FMSF argued, were getting women to think of themselves as incest survivors-society's most disturbing victims and were shattering families.

The FMSF quickly catalyzed a national debate over therapeutic accountability and the nature of memory, nearly frightening therapists out of their wits. By the end of 1994, they had 4,000 members. One social worker on the eastern seaboard, sued by a young woman who had recanted charges of parental sexual abuse, went into administrative work and stopped taking private clients. In the Midwest, a therapist who had worked successfully for 20 years with incest families developed stacks of new informed consent forms. A psychologist in the Northwest called a colleague in a panic, wondering whether she should turn down a new client whose parents had already joined the FMSF.

For the first time in history, therapists faced a well-organized, furious and effective grass-roots opposition group. And when the parents told their stories, it was clear that therapists had given them plenty of ammunition.

One mother said that her estranged daughter, dying of a rare bone disease, had read aloud a list in a therapy session, accusing the mother of emotional neglect and of allowing her daughter's alcoholic father to sexually abuse her. According to sociologist Richard Ofshe's 1994 book, Making Monsters, it was the last time that the mother saw her daughter alive.

"Your symptoms are so classic, I'm blown away, actually," another therapist said, as she diagnosed repressed memories of abuse in a woman who turned out to be a CNN reporter presenting invented symptoms of depression.

"Retractors," some of them emotionally vulnerable survivors of genuine childhood trauma, told disturbing stories about therapy that had made them worse. Among them was Lynn Price Gondolf, a Texas woman suffering from bulimia, who had never forgotten being repeatedly raped by her uncle when she was a child. Her therapist, she tells Elizabeth Loftus in The Myth of Repressed Memories, paid little attention to helping her stabilize her life. Instead, he encouraged her to join a therapy group apparently dedicated to a kind of emotional strip-mining. Within two months, she had visualized her parents abusing her as well, and had confronted them for not protecting her. She subsequently tried to commit suicide five times, was repeatedly hospitalized, and, she said, only got better after her insurance benefits ran out and her therapist stopped seeing her. And many infuriated fathers said that after their daughters entered therapy, they'd gotten letters describing repeated and horrible childhood sexual abuse that the fathers said was the farthest thing from their minds.

Some of the cases could be explained as the protests of abusive parents who did not remember, or the botched work of that inevitable minority of impaired or incompetent professionals scattered through all fields, including medicine, car repair and the law. "I read the retractors' stories of sitting around pounding on pillows and screaming for hours, and I know we've got bad therapy," concedes Laura Brown, a psychology professor at the University of Washington and a member of the American Psychological Association's Working Group on Childhood Memory. "But people do bad therapy in a variety of ways, and we've had evidence of that for years." Something else was at work as well: when clinicians began to treat incest, they were working without much of a tradition to inform them, in an area where therapists had rarely gone before.

Before 1980, incest was one of psycho-therapy's black holes. Most psychotherapy training programs did not mention it at all. The leading psychiatric textbook of the 1970s said it occurred in one in a million families. Sex researchers in Alfred Kinsey's group declared (without research) that sexual contact between adults and children was usually harmless unless someone made a fuss about it once it was discovered. Most early family systems theorists ignored it, just as they had previously ignored or talked around wife battery.

In the early 1970s, when Harvard psychiatrist Judith Herman, author of Father-Daughter Incest, began seeing clients who told her they'd been sexually abused, her supervisors routinely "reminded" her that women often fantasize or lie about incest. Many such women, understandably, carried the incest secret through numerous psychiatric consultations and hospitalizations to their graves.

This political and clinical context began to change with the feminist movement of the 1970s. Painful truths were told at speakouts on incest and rape, at 12-step meetings, and to lovers and friends. In 1980, in a rare piece of positive fallout from the Vietnam War, the long-lasting effects of trauma of all kinds including rape, sexual abuse, torture and combat-were officially and belatedly recognized in a new DSM-III diagnosis, Post-Traumatic Stress Disorder.

In 1988, when there was still a relative dearth of informed clinical literature on incest, The Courage to Heal written by non-therapists Laura Davis and Ellen Bass of Santa Cruz, California, was published. At a time when many women would still have been too embarrassed to pick up such a book, it told hundreds of thousands of survivors that they were not alone. Countless others, it said, shared their nightmares, intrusive images, promiscuity, anger, numbness and difficulties with trust and sexual pleasure. But it confused social action and individual healing, held out little hope for family reconciliation, and approvingly described a woman disclosing her brother's sexual abuse to the guests at his wedding. And it sold like hotcakes.

It was in this cultural climate that a new group of clients mostly financially independent middle-class women who paid their own therapy bills or had their own insurance began, in the 1980s, to disclose abuse to thousands of therapists, many of them also women. That is why incest therapy has been exploratory, iconoclastic, empirical, intuitive, feminist, and improvised. It made itself up as it went along. Many of its grass-roots practitioners ignored research (which had previously told them that incest occurred in one in a million families) and clinical tradition (which had previously explained that most abuse memories were either overrated or wishful thinking). But they listened to clients.

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