Wednesday, November 01, 1995


The following article appears in the current issue of TREATING ABUSE TODAY magazine, November-December 1995/January-February 1996



In a move that left many APA members puzzled and angry, the American Psychological Association (APA) recently approved the False Memory Syndrome Foundation, Inc (FMSF) as a provider organization able to offer continuing education for psychologists. This approval indicates that the APA recognizes the FMSF as an organization capable of planning and implementing educational programs for psychologists at the post-doctoral level. The APA approved this status despite its own earlier warning that the legislative agendas of many state FMS organizations posed a serious threat to the mental health professions, and to the general availability of quality mental health services. [1]
In a recent interview, Rhea Farberman of the APA's Public Affairs Office justified the APA's decision as "non-political," based solely on the merits of the FMSF's application for continuing education (CE) provider status. She characterized FMSF stances, including the debated existence of "false memory syndrome" itself, as "unpopular science." She stressed, however, that the APA would not deny CE provider status to any organization simply because its science proved unpopular with most practitioners. She further stated that the APA felt "a real responsibility" to protect "research, data, and science."

Farberman stressed, however, that people shouldn't confuse the CE sponsor approval with any kind of general or specific APA endorsement of the FMSF. She pointed out that, in fact, the APA found many FMSF positions, practices, and actions "troubling." She also stated that many FMSF board members espoused positions and acted in ways unacceptable to the APA.

According to Jill Reich, PhD (the Executive Director of the APA Education Directorate), CE sponsors must offer educational resources that improve professional competence, make available new skills and knowledge, and encourage critical inquiry and balanced judgment. Reich further stated, however, that the APA's Committee for the Approval of Continuing Education Sponsors (CACES) doesn't consider program content during the approval process; rather, the Committee considers only the formal elements of an organization (structure, management, instructors, and so on).
When asked how the APA, without looking at program content, could possibly know whether or not a particular organization met the above criteria, Farberman indicated that an organization's past educational activity and the presence of reputable specialists on the organization's board offered sufficient assurance that it would meet the criteria. In a published statement, Reich confirmed this view when she indicated that the FMSF application "provided ample evidence that the organization is capable of offering continuing education that benefits psychologists and has, in fact, done so in conjunction with another organization, Johns Hopkins University." [2]
The FMSF, however, apparently takes a much more rigorous view regarding the need for oversight of CE program content. In a recent fundraising letter (dated November 1, 1995), representatives of the FMSF stated:
Professional organizations still do not hold their members accountable. Too many continuing education programs still continue to disseminate unscientific information about memory, repression and therapeutic techniques that destroy families.
Assuming that the FMSF includes the APA among these "professional organizations," it appears that the FMSF faults the APA for not scrutinizing the content of CE programs. The FMSF, however, has now taken advantage of the very weaknesses of a system that it earlier condemned. When asked about the apparent contradiction, the APA's Farberman characterized it as "ironic."
Many outraged APA members argue that the FMSF would fail the scientific scrutiny it once called for, because (the members maintain) this advocacy organization regularly participates in activities that make a mockery of the scientific endeavor. Other observers argue that the FMSF fails to meet all three of the APA criteria for approving a CE sponsor, especially regarding the need to encourage critical inquiry and balanced judgment. Charles Whitfield, MD, for instance, stated that "the FMSF's conferences and other educational offerings have always been greatly unbalanced in favor of promulgating their one-sided claims." Other APA members argue that the FMSF goes beyond bias to push a pseudoscience based on a "syndrome" that no reputable medical or psychological body recognizes; yet the very same organization regularly cries "bad science" against researchers, clinicians, and organizations (the APA included) who take a skeptical view of FMSF claims.

In a recent letter of resignation from the APA, for example, Elizabeth Loftus, PhD [3] (a prominent FMSF board member) claimed that "APA subgroups and members have moved in directions that are disturbingly far from scientific thinking." She further stated that she decided to resign so she could "devote [her] energies to the numerous other professional organizations that value science more highly and more consistently" than the APA.

In this statement, of course, Loftus doesn't speak for the FMSF generally, although her claims echo other FMSF claims made elsewhere (such as in the fundraising letter cited earlier). Some observers, however, find themselves struck by the oddity of the situation: A prominent FMSF board member resigns from the APA--citing irreconcilable scientific differences--shortly after the APA grants CE sponsor status to the FMSF, so the organization can teach its brand of "science."

Other FMSF critics wonder just how closely the APA scrutinized the FMSF "instructors," presumably the members of the FMSF's Scientific and Professional Advisory Board. Almost exclusively, the Board includes members of the academic staff of colleges and universities, with the odd magician and author thrown in for spice. Despite the impressive variety in the backgrounds of the board members, very few of them command clinical or research expertise in trauma and abuse issues, the very issues that the organization would teach to psychologists through its CE offerings.

In many ways, Reich's published statement regarding the FMSF's CE sponsor approval suggests that the Committee generally adopts a position of assumed helplessness within the strictures of "rules and procedures." At several points in her statement, Reich explicitly absolves the Committee of any responsibility for its decisions. She states, for instance, that "the Committee has no authority to act" as a rational decision-making body; rather, it can only act as a cogs-and-gears mechanism set in motion by higher echelons within the APA. In short, the Committee "follows specific procedures approved by the Council of Representatives, and deals only with the evidence before it."

In true mechanistic fashion, once the Committee winds the spring and sets the approval mechanism in motion, it "has no basis on which to reconsider its decision." In other words, the Committee has no power to change its collective mind. Those APA members dissatisfied with a Committee decision can get it changed only by throwing a wrench into the works. The only acceptable wrench, according to Reich, must come in the form of a written complaint. Farberman also stressed the conditional nature of the CE approval granted to the FMSF, and she stated that the organization will have to follow a standard cycle of review and approval. Reich stands by these procedures, despite the feeling among many APA members that the review and complaint process amounts to a lengthy bureaucratic shuffle to shut the chicken coop after the weasel's already inside.

Despite the aggravation inherent in the APA's after-the-fact approach, a number of APA members have already written letters of complaint. In two open letters, Kenneth Pope, PhD argues that FMSF activists use a number of disturbing tactics, such as: accosting the staff and clients of therapists; maintaining "picket lines" (really gauntlets that clients must walk to get to the offices of their therapists); encumbering resources through legal and administrative ploys; covert investigations using private investigators to infiltrate therapy practices; and making repeated in absentia psychological diagnoses of people (sometimes whole groups of people) who disagree with FMSF stances. Pope argues that such tactics may keep some mental health professionals from publicly expressing disagreement with FMSF stances.

Farberman stated that the APA has no knowledge that the FMSF uses such tactics. She indicated, however, that the Education Directorate would act on complaints received from members who attended an FMSF activity and found any practice objectionable. She expressed particular concern over the possible development and distribution of blacklists, though she stressed that the APA had no evidence that the FMSF had involved itself in such activities.

At an October 1995 Pennsylvania State FMSF meeting, however, Pamela Freyd, PhD (the FMSF Executive Director) stated that her organization's next "big project" involved the development and distribution of a roster listing "thousands" of clinicians that FMSF members have identified as therapists "destroying families." At the meeting, she called for volunteers to help with the daunting task of data input, to get the roster off and running. At the same meeting, an attorney discussed ways to mount media campaigns against "bad" therapists without risking libel, and ways to encumber the resources of "bad" therapists through administrative complaints and legal suits.

Early last year, the APA recognized that at least one item on the FMSF agenda constituted a severe threat to the psychological profession. In a 1995 APA Action Alert issued under the authority of Billie Hinnefeld, JD, Director of Legal and Regulatory Affairs, the APA warned that FMSF-inspired legislation "threatens to inappropriately curtail psychotherapy and make needed mental health services inaccessible to the public." When contacted for a statement regarding the APA's most recent decision regarding the FMSF, Hinnefeld refused to comment beyond pointing out that the Practice Directorate and the Education Directorate make up two entirely separate APA functions, and that neither has to answer for the decisions of the other.

A source who requested anonymity also pointed out that Ray Fowler, PhD, the Chief Executive Officer of the APA, stated that this controversy amounts only to a "PR" issue with some APA members. According to Farberman, however, Fowler understands that the controversy involves issues that go much deeper than skirmishes in public relations. Fowler didn't return repeated calls asking for comment.

The "organizational dissociation" inherent in the APA's stance reflects the inevitable "professional dissociation" in a field as complex as psychology. Some psychologists, for instance, strongly support the APA's decision despite the fact that the FMSF teaches about a "syndrome" that has no clinical or academic underpinnings, and that the profession itself hasn't recognized. Ira E. Hyman, Jr, PhD, for instance, argues that "the FMSF [can] put together an educational program concerning repressed memories and false memories that would be useful to academics and clinicians" (Internet posting, November 26, 1995). [See note from Dr. Ira Hyman.] After briefly discussing an FMSF conference held at Johns Hopkins Medical Institutions in December 1994, a conference that included an "impressive" list of presenters, Hyman concludes, "If the FMSF can put together such programs, then my view is that they are an appropriate group to offer credits for APA members."

Hyman fails to point out, however, that the presenters at this conference came almost exclusively from FMSF ranks, a fact that hardly bodes well for a rounded treatment of clinical issues. He also doesn't mention that, shortly before the Johns Hopkins conference, the FMSF failed to gain state CE credit for a Washington State (US) FMSF conference, even though this conference featured many of the same presenters as the Johns Hopkins conference. In announcing the failure, John Cannell, MD (the conference organizer) stated that "the Medical Association here commented on the quality of the presenters." Hyman, who lives in Washington State, serves as a faculty member in the Psychology Department of Western Washington University.

According to Farberman, the APA recognizes the shortcomings of current CE approval procedures, and she stated that the organization would undertake a detailed review of the procedures. She stressed, however, that the APA remains committed to an ideal of open inquiry and non-censorship in scientific endeavors.

To directly express your views on this or any other matter involving the American Psychological Association, call or write:
750 First Street, NE
Washington, DC 20002-4242
(202) 336-5500 (voice) (202) 336-5708 (fax) (202) 336-6123 (TDD)
[1] For a fuller discussion of this earlier APA warning, please see "APA Speaks Out Against Bureaucracy and Barriers to Service" in Vol 5, No 2 of TREATING ABUSE TODAY.
[2] Reich appears unaware of the controversy surrounding the odd-bedfellows relationship between Johns Hopkins, a venerable medical institution, and the FMSF, a media-savvy advocacy organization. A great many mental health professionals were astounded when Johns Hopkins apparently embraced "false memory syndrome," when no psychological or medical organization has yet recognized its existence. In fact, Paul McHugh, MD--a prominent Johns Hopkins psychiatrist--orchestrated the partnership between the FMSF and Johns Hopkins. McHugh also serves on the Scientific and Professional Advisory Board of the FMSF.
[3] For more information on Loftus's resignation from the APA, please see "Ethics Charges Filed Against Prominent FMSF Board Member," in the same issue of TREATING ABUSE TODAY (Vol 5 No 6/Vol 6 No 1).

No comments: