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Persuasive Techniques - Contemp Cults

Cultic Studies Journal, 1990, Volume 7, Number  2, pages 126-149


Persuasive Techniques in Contemporary Cults: A Public Health Approach

Louis Jolyon West, M.D.

Professor of Psychiatry

UCLA Medical School


Abstract


The persuasive techniques used by totalist cults to bind and exploit their members, while not magical or infallible, are sufficiently powerful and effective to assure the recruitment of a significant percentage of those approached, and the retention of a significant percentage of those enlisted. (The term “significant” here refers to an amount sufficient for the enrichment of the leadership and their accumulation of power.) Such cults are a genuine menace to society because they cause harm to personal families, and the community. Whatever good they do could be done as well or better by other organizations (i.e., benign religious groups, legitimate health professions, and so on) that do not pose the same types of risks to individuals and to the public. The extent of cult-related harm during the past 20 years is sufficient to justify describing it as an epidemic, and calling for a public health approach to the problem. The exercise of such an approach should reduce the number and power of cults, and thus reduce the amount of harm they do, without posing any risk to freedom of religion or to nontotalist organizations.

There are two very different public images of contemporary organizations which for the purposes of this essay I shall call cults, (see discussion of definition, below), especially those cults to which the adjective "religious" is usually applied. The first image might be called utopian. It suggests the emergence of a healthy, new spiritual sectarianism, a flowering of "new re4ons' (a term held preferable to “cults” by their supporters). This image portrays congregations of pilgrims who, after a search for truth, self-fulfillment, or the meaning of life, have found a band of kindred spirits under the benign guidance of a divinely inspired prophet, guru, master, or paterfamilias, with whom they are now living happily. Their bliss is rarely troubled by memories of the rejected -- perhaps doomed -- society left behind, or by the attempted intrusions or “rescue” efforts of unenlightened, misguided family members or their agents.

Fortunately, the wealth and strength of the cult is usually sufficient to foil the schemes of these outsiders. Against such schemes can be arrayed the power of the group, of its well-supported attorneys citing various laws including those that protect freedom of religion, and of numerous friendly organizations and sympathetic individuals in all walks of life.

The opposite image might be called infernal. This invokes the spirit of Dante Alighieri and his fourteenth-century vision of hell Through Dante's eyes we see a place where men, women, and children are bound to a satanic master. They trusted him in the beginning and believed his promises, but now they are sinking deeper and deeper into his power, surrendering their possessions, their bodies, their children, their very souls to his mysterious purpose. With Dante we follow them to a distant place, where "sighs, lamentations, and loud wailings resound through the starless air,” making us weep in sympathy. We hear “words of pain, tones of anger, voices loud and hoarse, and with these the sound of hands, (making) a tumult which is whirling through that air forever, as small eddies in a whirlwind.” Above the cries of the damned, we might hear a single child's voice calling out, “I'd die for you, Dad.” These were the tape-recorded words of a boy just before he took the fatal poison at the command of Jim Jones: Guyana's twentieth-century echo from Dante's Inferno.

These public images are mirrored by the propositions and publications of two groups of behavioral scientists and health professionals, using more technical terminology but with similar general orientations to the “utopian” versus the “infernal” (i.e., those '”ympathetic” toward “new religions” versus those “critical” toward “cults”). Because there are relatively few scholars in this field, the players on the two sides are fairly well known -- at least by name -- to each other and to those who for one reason or another have a stake in the contest. Unfortunately (but perhaps inevitably) these scholars have become increasingly polarized and, as the public debates over cult-related matters multiply, have been pitted against each other as expert witnesses in lawsuits and in other arenas as well. The characteristics of these opposed groups, their allies, shibboleths, self-images, and perspectives about each other, comprise a topic of great interest in its own right, but about which space does not permit discussion here.

I have been following the phenomena of cults in America since 1950 when Dianetics burst upon the scene, originally as a psychotherapy cult, later to become the Church of Scientology. However, my continuing interest in these groups represents the confluence of several lines of inquiry. One has to do with studies of hypnosis and dissociative phenomena (1). The second has to do with coercive persuasion and the techniques employed in the Korean War by communist captors to induce a number of American prisoners to behave in ways deemed improper, or even treasonous (2,3). The third related to abuse by youth of alcohol and drugs (especially hallucinogens) and the flight by many young people from the drug-abuse subculture into communes and (later) cults (4). The fourth is that of a clinical psychiatrist who must evaluate the psychopathology of patients who happen to be cult victims, specify their diagnoses, undertake treatments, evaluate therapeutic outcomes, and teach others to do the same (5).

The perspective on cults that I have developed is neither utopian nor infernal. It is, I hope, objective and scientific. However, I must admit that on occasion, when faced with some particularly shocking example of abuse of a cult member (espe6aUy a child) by the group or its leaders, to remain objective I have had to employ all the training and experience accumulated during nearly 40 years in the practice of medicine. I have learned so much about the suffering of cult victims and their families that I have come to regard cults as a public health hazard, and thus find myself in the camp of critics.

There are many religious sects, new and old, that I would not classify as cults. Cults are best identified by the authoritarian fashion in which they actually function rather than by their benign public image; by their de facto value systems largely based on power, money, and aggrandizement of the leaders rather than their alleged humane concerns, charitable practices, or spiritual enrichment of the followers; by their secretive practices, jealously guarded boundaries, and tough rules about the flow of information rather than their outward pretenses of openness, candor, and honesty.

Most cults undoubtedly are neither utopian nor infernal. At any given time, a number may be relatively harmless. But most -- if not all -- have the potentiality of becoming deadly, as the People's Temple of Jim Jones did. Some cults that currently may appear harmless are in fact already doing serious damage about which the general public knows nothing, damage that cult leaders cover up and deny, damage that apologists for cults consistently refuse to admit or inspect.

Some of the larger, more powerful cults have branches in many countries, extensive property holdings, subsidiary organizations with special names for special purposes, and a growing degree of influence. International concerns about the detrimental effects of certain cults on the well-being of their members, members' families, and society in general have led to such varied actions as a national conference on the problem in West Germany in 1981, resolutions against cults by the American Parent Teacher Association (FITA) in 1982 and by the European Parliament in 1984, a nationally televised debate in Spain in 1984, the international Wingspread Conference on Cultism (Johnson Foundation Wingspread Conference Center, Racine, Wisconsin, 1985), the Vatican Report of 1986 (6), and an Israeli interministerial report in 1987. (The Israeli report denounced 10 groups [including Divine Light Mission, Church of Scientology, Unification Church, and the Hare Krishnas] causing “a form of dependence, bondage, self-enslavement” and loss of property. After receipt of this report the Education Ministry warned that such cults promote rifts between their members and society that ”can significantly affect the individual's judgment, autonomy, and ability to make a choice.”) Other governmental investigative reports have been carried out in Australia, Canada, France, and elsewhere.
Definition

The word cult is given several definitions by the dictionary (7). These definitions include the following.

4. A religion regarded as unorthodox or spurious (the exuberant growth of fantastic cults); also, a minority religious group holding beliefs regarded as unorthodox or spurious.

5. A system for the cure of disease based on the dogma, tenets, or principles set forth by its promulgator to the exclusion of scientific experience or demonstration.

6a. Great or excessive devotion or dedication to some person, idea or thing.

6b. The object of such devotion.

c(l): A body of persons characterized by such devotion (America's growing cult of home fixer-uppers -- Wall Street Journal).

Some of Webster's other definitions are even broader or more benign.

Needless to say, my concerns are not about cults of “home fixer-uppers.” Rather, I am concerned about fanatical groups capable of exploiting or harming their own members, disrupting or destroying members' families, and threatening or even attacking critics, former members now defined as traitors or renegades, or any person or group seen as opposed to their activities -- not excluding government agencies, university scholars, or entire professional entities (e.g., psychiatry).

In this article, I use the term 'cult' to describe groups that satisfy one or another of Webster's definitions but that also can properly be described as totalist, after Lifton (8). Lifton derived his concept of totalism from Erick Erikson's contribution to Totalitarianism (9). Totalism describes a tendency to “all-or-nothing emotional alignment” which can be exploited by “those ideologies which are most sweeping in content and most ambitious -- or Messianic -- in their claims, whether religious, political or scientific. And where totalism exists, a religion, or political movement, or even a scientific organization becomes little more than an exclusive cult” (p.42,9). In a later work, Lifton explicates “a dangerous four-step sequence from dislocation to totalism to victimization to violence” (10).

The following definition (similar to the one employed in the Wingspread Conference report) is provided for the reader of this article to understand my meaning as clearly as possible.

Cult (totalist type): a group or movement exhibiting a great or excessive devotion or dedication to some person, idea, or thing, and employing unethical manipulative or coercive techniques of persuasion and control (e.g., isolation from former friends and family, debilitation, use of special methods to heighten suggestibility and subservience, powerful group pressures, information management, promotion of total dependency on the group and fear of leaving it, suspension of individuality and critical Judgment and so on) designed to advance the goals of the group's leaders, to the possible or actual detriment of members, their families, or the community.

Totalist cults are likely to exhibit three characteristics: 1) excessively zealous, unquestioning commitment to the group and its leadership by the members, 2) manipulation and exploitation of members, and 3) harm or the danger of harm. It should be noted that many groups do not fit neatly into a category of sect, commune, or cult. Furthermore, groups may change their characters over time, becoming more or less like cults, totalist or otherwise.

Terms such as “new religious movement” have been used by some to describe certain cultic groups. A problem with " approach is that it may lend unwarranted respectability to a less-than-respectable enterprise. Jim Jones's People's Temple was once considered a new religious movement. The term is also inappropriate to describe cultlike groups that are not religious; or groups of devotees that form around charismatic healers who then exploit their patients and followers in various ways; or nonprofessional psychotherapies, even if they convert themselves to “religions” in order to obtain various tax benefits and legal protections; or cabals of Satan worshippers which, while perhaps qualify as “religious,” could hardly qualify as "new.”

Henceforth the reader should understand that in this essay I use the word 'cult' to mean 'totalist cult' as defined above.
The Scope of the Problem

The old and the young may be involved in cults, as demonstrated by the membership of the People's Temple and demography of the dead at Jonestown. However, persons between the ages of 18 and 30 are especially subject to cult recruitment. A recent study of students in San Francisco found that half were open to accepting an invitation to attend a cult meeting; approximately 3 percent reported they already belonged to cultic groups (11).

My own observations, and those of colleagues whose judgment I respect, have led me to believe that no single personality profile characterizes those who join cults. Many wefl-adjust4 high-achieving persons from intact families have been successfully recruited by cults. So have individuals with varying degrees of psychological impairment. However, to the extent that predisposing factors exist, they may include one or more of the following: naive idealism, situational stress (frequently related to normal crises of adolescence and young adulthood, such as romantic disappointment or school problems), dependency, disillusionment, or an excessively trusting nature. ignorance of the ways in which groups can manipulate individuals is a relatively general characteristic of cult victims -- until it is too late.

From a public health perspective, we are currently dealing with an epidemic of cult-related damage. It has been estimated that there are now more than 2,500 cults in the United States. The majority of these are religious and, of course, they are not all alike. Some are very small -- 15, 30, or 50 people, and resemble communes. By my criteria (5), cults and communes differ in three main aspects:

1. Cults nearly always have a strong, charismatic leader with a power structure of some kind; communes generally do not.

2. Cults are likely to have a manifesto -- a book, a doctrine, a code -- which, as interpreted by the leader, governs the behavior of the members through various rules and regulations; in communes one is more likely to find tracts on astrology or organic gardening.

3. Cults are surrounded by a tough boundary that clearly defines who is in, who is out, and who may pass in either direction; communes, on the other hand, are generally open to people coming and going, often from one communal setting to another.

As noted previously, many cults pose significant threats to the personal freedom and well-being of their members. Nevertheless, despite all the evidence of misdeeds perpetrated in the name of religion, these threats are, to a considerable degree, covered up, minimized, and obscured. This covering-up process is part of the condition that has enabled the epidemic to spread.

Much information has accumulated from various cult-related scandals -- from cult refugees; from families, relatives, and friends of cult victims; and from a few studies. However, it is very difficult to obtain accurate data by direct investigations of cults because the cults systematically deceive the public. They conceal information; they harass their critics; they intimidate and dominate their members. All of this is designed to prevent a free flow of information.

Sometimes I am astonished to hear a colleague report that he or she has visited a certain cult and has been persuaded that the people there are happy and content, or that he or she has distributed questionnaires to cult members and drawn similar conclusions from results. Naive visitors may not see through the choreographed presentation regularly provided by cults to deal with outsiders, but scientists should not be so easily deceived. Former cult members have come forward to say, "But look, I was there! I took part in the deception! It is a well-practiced act that we always put on to deceive outsiders!” The investigator who is sympathetic to the cult may retort, “You are not a good reporter because, as a former member, your account is prejudiced. Even if you did live six or seven years in the cult, the very fact that you left proves that you are now biased and, therefore, your testimony is worthless.”

It is hard to carry out good scientific research under conditions where genuine direct access to -- or truly unrestricted observation of -- the phenomena or subject material is forbidden, and where the cult leadership controls or can influence the circumstances of scrutiny, the choice of subjects, or the nature of the responses. Even so, existing data now suffice to convince any reasonable person that the claims of harm done by cults are bona fide. There are a good many people already dead or dying, ill or malfunctioning, crippled or developing improperly as a result of their involvement in cults. They are exploited; they are used and misused; their health suffers; they are made to commit improprieties ranging from lying (“heavenly deception”) to murder. Their lives are being gobbled up by days, months, and years. Their families are often devastated.

For at least two decades the situation has been growing steadily worse. We do not know how many people are affected. I have seen estimates that as many as 10 million Americans have been at least briefly involved with cultic groups during the past 20 years. But even if it were only a million, the situation should be considered grave. Suppose a million people in the United States were afflicted with some mysterious infection about which many victims did not complain, but which caused considerable suffering in others and, while only a small percentage di4 that was affecting a steadily increasing number of people. Would we not consider that an epidemic? I submit that we would, and that a public health approach would be considered an appropriate response by those responsible for public policy.

In spite of such evidence, however, there are many apologists for the cults. These individuals and organizations undoubtedly contribute to the cults' veneer of respectability behind which strange and ugly things are happening. Some of the apologists appear to be romantics. They project into the cults some of their own hopes for religious reform, spiritual rebirth, rejection of materialism, or even escape from the dangers of the thermonuclear age. Other apologists, including some civil libertarians, take a more seemingly pragmatic stand, shrugging off whatever abuses the cults may perpetrate, and pointing out that any countermeasures would be unacceptable be-cause they might violate freedom of religion as guaranteed by the First Amendment to the Constitution of the United States.

A number of apologists appear to have been successfully deceived by charismatic cult leaders or their representatives. Certain politicians fall into this category, in some cases after the cult has contributed money to their election campaigns. There are even some armchair philosophers who have either never seen the destructive effects of cults or prefer to deny their reality, but who happily discuss cults (perhaps using another definitions) at great length and in the most elaborate terms as an interesting new ferment in contemporary society, or in some other uncritical way. If the apologists are church officials, physicians, or behavioral scientists, the grateful cults have been known to reward them with grants, awards, published praise and even “research” opportunities.
Cult-Related Harms

The Wingspread Conference, (12) pointed out that cults arouse concern because of their unethical or manipulative practices together with their lack of consideration for the individual's needs, goals and social attachments. Of even graver concern is that these practices often result in harm to persons, families, and society at large. A number of specific harms are outlined in the Wingspread Conference Report, which appeared in " journal previously (1986). These harms are broken down into five general areas: (1) individuals and families; (2) government and law; (3) business; (4) education; and (5) religion.

Although the Wingspread outline of harms is fairly comprehensive, it does not include a classification for certain major crimes, such as fraud, rape, battery, and murder, which have been committed at the instigation of cult leaders or in cult settings.

It should be understood that the Wingspread Conference was by no means the first review of cult-related hazards, nor the first aegis under which recommendations were made for a realistic public response. The Wingspread Report, for example, quotes a resolution adopted by the 1982 National FTA Convention delegates. Two years after the FITA resolution, on May 22, 1984, the European Parliament adopted a Resolution entitled New Organizations Operating Under the Protection Afforded to Religious Bodies. The Resolution expresses the Parliament's concern about the recruitment and treatment of members of the organizations in question and calls for an exchange of information among member states on problems arising from the activities of these groups with particular reference to charity status and tax exemption; labor and social security laws; missing persons; infringement of personal freedoms; existence of legal loopholes which enable proscribed activities to be pursued from one country to another; and creation of centers to provide those who leave the organizations in question with legal aid, assistance with social reintegration, and help in finding employment.

The Resolution states that 'the validity of religious beliefs is not in question, but rather the lawfulness of the practices used to recruit new members and the treatment they receive.' It goes on to call upon member states to pool their information about the 'new organizations' as a prelude to developing 'ways of ensuring the effective protection of (European) Community citizens.' To achieve this, the Resolution .recommends that certain criteria be applied in investigating, reviewing, and assessing the activities of the above-mentioned organizations.' [See David Wilshire's article in CSJ Vol. 7, No. I for background on this important resolution and a list of these criteria -- Editor.]

The Resolution of the European Parliament concludes by stating that it is desirable to develop “a common approach within the context of the Council of Europe,” and “calls therefore, on the governments of the Member States to press for appropriate agreements to be drawn by the Council of Europe which will guarantee the individual effective protection from possible machinations by those organizations and their physical or mental coercion.” The provisions of the Resolution clearly reflect the experience of harm suffered by thousands of cult victims and their families in the European community.
Persuasive Techniques

The scholars who prepared the 1986 Vatican Report (6) summarized their findings in a list of such methods that is similar to listings by others (5,13), but perhaps should be reproduced here because it comes from a clerical source outside the ongoing debate.

Some recruitment, training techniques, and indoctrination procedures practiced by a number of sects and cults, which often are highly sophisticated partly account for their success. Those most often attracted by such measures are those who, first, do not know that the approach is often staged and, second, are unaware of the nature of the contrived conversion and training methods (the social and psychological manipulation) to which they are subjected. The sects often impose their own norms of than feeling, and behaving. This is in contrast to the Church's approach which implies full-capacity informed consent.

Young and elderly alike who are at loose ends are easy prey to those techniques and methods that are often a combination of affection and deception (e.g., love-bombing, the personality test, or the surrender). These techniques proceed from a positive approach but gradually achieve a type of mind control through the use of abusive behavior modification techniques.

The following elements are to be listed.

• Subtle process of introduction of the convert and his gradual discovery of the real hosts;

• Overpowering techniques: love-bombing, offering a free meal at an international center for friends, Flirty fishing techniques (prostitution as a method of recruitment);

• Ready-made answers and decisions are being almost forced upon the recruits;

• Flattery,

• Distribution of money, medicine;

• Requirement of unconditional surrender to the initiator, leader;

• Isolation: control of the rational thinking process, elimination of outside information and influence (family, friends, newspapers, magazines, television, radio, medical treatment, and so forth) which might break the spell of involvement and the process of absorption of feelings and attitudes and patterns of behavior;

• Processing recruits away from their past lives, focusing on past deviant behavior such as drug use, sexual misdeeds; playing upon psychological hang-ups, poor social relationships, and so on;

• Consciousness-altering methods leading to cognitive disturbances (intellectual bombardment); use of thought-stopping clichés; closed system of logic; restriction of reflective thinking;

• Keeping the recruits constantly busy and never alone; continual exhortation and training in order to arrive at an exalted spiritual status, altered consciousness, automatic submission to directives; stifling resistance and negativity, response to fear in a way that greater fear is often aroused;

• Strong focus on the leader; some groups may even down-grade the role of Christ in favor of the founder (in the case of some Christian sects).

Much of the cult controversy relates to the question of whether it is actually possible for groups or authority figures to influence and control the thoughts and behaviors of subject individuals to their detriment.

In the secular world there is general acceptance that such influence and control are very real. Intimidation through force or the threat of it is a powerful controller of behavior, and thoughts tend to follow behaviors through rationalization, self-justification, identification with the aggressor and other mechanisms. Deception is also a well-known method of exploiting people, either through positive misinformation, concealment of important facts, or both. Our statutes, ethical codes, and conventional moralities all recognize and accept the vulnerability of people to intimidation and deception. However, this scenario assumes that the wronged person eventually recognizes and decries his or her victimization. The wronged person presses charges. He or she shows his or her bruises. The wronged person produces evidence that a swindle occurred, that the product was misrepresented, that the lot is under water at high tide. Maybe the wronged person wins the case; maybe not. Perhaps it is deemed the individual's own fault that he or she didn't read the fine print, or that he or she didn't exercise reasonable suspiciousness or prudence. Caveat emptor still obtains despite consumer protection laws. Nevertheless, the reality and effectiveness of intimidation and deception are not an issue per se. Someone has done it to the victim. The victim didn't do it to himself or herself. Cults are able to operate successfully because at any given time most of their members are either not yet aware that they are being exploited, or cannot express such an awareness because of uncertainty, shame, or fear. That there are techniques capable of drawing people into such groups, holding them there, even to their detriment, and influencing their mood, thought and behavior while they remain identified with the group is a hinge of major controversy in this field.

Terms like “brainwashing” are not useful in exploring this question. “Brainwashing” did not prove necessary to account for the unwonted behaviors of prisoners of war (2,3,14,LS). “Mind control” is not much better. The realities about techniques of influence do not require neologisms to assert themselves. They may be found in several bodies of literature, to which the reader is here referred through the following list of examples.

1. Laboratory experiments with normal human subjects (16-19).

2. Studies of coercive persuasion or thought reform, outside the cult field (20-29).

3. Studies of accounts by former cult members, surveys, and single-group overviews (30-47).

4. Investigative studies of cultlike organizations (48-61).

5. Reports by those who have treated cult victims (62-70).

My own “public health approach” was first proposed at the Bonn conference in 1981 (7). In the years that have passed since then I have come to believe with even greater certainty that this approach is deserving of consideration because it poses no threat to established religions, new religions, communes, sects (no matter how odd), or even cults if they are of the nontotalist variety. At the same time it tackles the hazards posed by cults, and the harms already suffered by their victims, and strives to protect those who are at risk or may become so.

In public health (including preventive psychiatry) we talk about three types of prevention: primary, secondary, and tertiary. Primary prevention eliminates the causes of illness or unhealthy circumstances. Secondary prevention intervenes early, striving to restore health and prevent recurrence of complications. Tertiary prevention (postvention) comes later, and seeks to diminish the damage and protect the victim from further harm. How can this model apply to cult-related harm?

The definition employed in this chapter is good enough to distinguish cults from genuine churches. Clearly it is essential that, in preventing cults from doing harm, we must not ourselves do harm to organizations that are blameless, and that society needs or desires for its well-being. Returning to the health-related model one might ask how, for the purposes of treatment, one distinguishes malignant Cells from healthy ones in the human body. A good approach, if one is interested in curing cancer, is to find a chemical that kills malignant cells and spares those that are healthy. What would be the effect of approaches which, when applied by society to organizations calling themselves religions, would have no untoward effect upon benign, bona fide religions, but would inhibit the malignant ones, that is, the cults? How could such social medications be prescribed?

Before outlining my suggestions, I wish to say a word about society's responsibility to support research on this problem. We must have a proper evaluation and monitoring of the cult epidemic, and measure the effectiveness of whatever methods we employ. Our society has a large stake in such research, but has not yet come to grips with the necessity to undertake it. If there had be-en an epidemic of an infectious disease with the morbidity and mortality of " one, research would abound.
A Public Health Model

1. Primary Prevention

With regard to our plague of cults, primary prevention requires strengthening society against them.

A. Recognition

The first essential under primary prevention is recognition of the nature and extent of the problem. This must include increasing public awareness and extensive public education. The PTA resolutions and the Wingspread Conference are mere beginnings to this process. Far more must be done.

B. Religious Outreach Programs

Many established religious entities have become smug, self-satisfied and preoccupied with the material state of the church rather than reaching out vigorously toward the idealism of the young. This cannot -- and in my view should not -- be accomplished through the schools, or through the dubious electronic propaganda of money-oriented radio and television 'ministries.' Rather, it should be the responsibility of "mainline” churches to bring to young people the benefits of religion through genuine religious fellowship. There is good reason to believe that such experience will render youngsters less vulnerable to phony but superficially attractive alternatives -- cults -- masquerading under the guise of religion.

C. Restoration of Family Values

While it is not good enough to say that the cult problem or its solution lies in the family, it is true that many families are in trouble. As part of primary prevention, there are many things that could be done to help families. Unfortunately, today there are many social factors, especially in the United States, that seem to militate against family integration. Vulnerability of young people to cults is not the only consequence of this disintegration. Increases in violence, drug abuse, crime, and delinquency all relate to serious problems in the family. While it does not appear to me that family problems are significantly more frequent in the backgrounds of cult recruits than in other persons with the same demographic characteristics, it is also true that interventions involving families have often proved helpful in solving cwt-related problems.

D. Risk Factor Review

How do we review risk factors as part of primary prevention in public health? We inspect. How do we know if it is safe to cat in a restaurant? A trained investigator is legally authorized to examine the food. In fact, inspections of many types of organizations purporting to provide for the physical or mental well-being of the citizenry are legally mandated. This is primary prevention in public health. Even the best hospitals must be inspected regularly. It seems to me that no responsible religious organization should raise objections to comparable inspections with regard to the risk of such harms as are reviewed above. The cults, of course, would be unable to withstand this type of scrutiny.

II. Secondary Prevention

The preventive measures discussed below have to do with requirements that I believe society can safely make directly upon the cults. These requirements will act, in the long run, like chemotherapy- to produce a specific effect on that which is harmful or diseased and to preserve the health of that which we desire to preserve.

A. Revelation

This means legally requiring any organization that purports to offer services of any kind, including mental or spiritual to reveal in advance all of the implications of participation or membership. In medicine we call this providing fully informed consent. Such a procedure should be made a requirement for any organization that recruits members from the public and in relation to their alleged purposes seeks special status or privilege regarding taxes or anything else. These organizations should be able to show that full disclosure was rendered before membership was solicited or accepted. It is not easy to become a Catholic, a Jew, or an Episcopalian. However, it is all too simple to become a Moonie. It usually happens before the recruit even realizes what has been done to bring it about. Most genuine religions, concerned with offering people spiritual fulfillment, strive to ensure in advance that such people know exactly what will be required of them, what their responsibilities will be. Not so the cults.

Many cults -- not only the Church of Scientology -- couch their claims of benefit in terms of health. We should insist that cult recruiters, like health professional if they propose to make you a healthier person, must explain all the risks to your health that the procedure -- or membership -- may impose, and what its actual limitations are. Under such a set of ground rules, the cheerful, smiling, clean-cut young person (often of the opposite sex) who befriends you and then says, “Would you like to come to a place I know and meet some wonderful people who are interested in the same things you and I are?” would be required to hand you a piece of paper saying “This is an invitation to attend and join the Unification Church. If you do join, the following will be required of you.” The list would include, among many other items, surrendering all personal possessions to the church, accepting Sun Myung Moon as the messiah, and living in celibacy until three years after marriage to a partner (who might well be a stranger) chosen by Sun Myung Moon.

B. Reckoning

This means accounting for the use of funds. Churches use most of their funds for operational expenses and charitable purposes, that is, for the improvement of the lives and well-being of their members, worthy projects in the community, care for the needy, foreign missions, and so on. There is nothing to fear in accounting for these expenditures. I know many thoughtful people in the clergy who for years have been saying that churches should open their books to appropriate inspection as businesses or hospitals must. Why not? Charitable expenditures should properly be tax-exempt. But if the goal of the church's fund-raising is to buy its leaders yachts, or jewels or Rolls-Royce limousines, or firearms, society has a right to know, and there should be a reckoning.

C. Removal

This has to do with the vital but delicate subject of removing a member from a cult for a period of objective review. When you look at this proposition as though it were a public health measure, it should not threaten the genuine religions. Simply put, if a reputable person or persons (e.g., a relative or a family) have a basis for being concerned about the health or well-being of a cult member, and a preliminary investigation shows that the concern has merit, that member might be removed from the cult for a short period of time to allow for examination of the situation by an objective agent of society, such as a court. This intervention need not require the type of conservatorship which necessitates proving the member incompetent. The only thing necessary would be to show reasonable grounds for concern about the member's physical or mental health.

Suppose there were a youngster at a Lutheran retreat and his parents thought: “I'm worried about him; his letters seem strange; I want him home.” The church would certainly not refuse to tell the parents where their youngster was, or to send him home. If society acknowledges that there are circumstances in which individuals are being endangered by certain types of organizations, then society must accept the responsibility to protect those who may be so endangered by removing them from the suspect situation until safety -- and genuine freedom of choice -- is assured.

D. Recovery of Damages

This is a potent social and legal remedy, which derives from the consumer advocacy tradition. If, after leaving an organization to which I previously belonged, I find that I have been harmed as a result of having been in that group, I should be able to sue the organization for the damages that I have experienced. To make a recovery for my losses, I would have to develop proof The establishment of proof may require investigations, witnesses, and even courtroom procedures.

Suppose someone decided to sue the Roman Catholic church claiming development of bad knees from too much kneeling. Collection of damages would not be likely because the person could have used a pillow, or because the church would not have expelled or punished him for not kneeling. However, suppose someone chooses to sue the Unification Church or the Church of Scientology for having exercised undue influence (a concept that already exists in law) upon his life, resulting in a loss of income, or of position, or of health, or of property, stating further that this undue influence employed deception, lack of initial full disclosure, or failure to give fully informed consent in advance. If proof were forthcoming, then such a lawsuit should lead to a recovery for damages. Ten years ago such suits were almost unheard of. Recently a few have been successful if lawsuits of this type increasingly lead to recovery of damages from totalist cults, the epidemic of cult-related harms will begin to subside.
III. Tertiary Prevention

A. Rescue Missions

Participating in the process of helping refugees from cults has proved to be one way for former victims to be useful and to stay healthy, something like the method used in Alcoholics Anonymous. However, rescuing people from cults can be risky. This brings us back to "removal” but further to the whole question of 'deprogramming,' which, although discussed satisfactorily in the Wingspread report, perhaps deserves a brief comment at this point.

What many parents call “removal” or “rescuing," the cults -- and often the police -- call kidnapping. I do not advocate kidnapping. But one must ask, what has gone wrong in society where parents are forced to kidnap their own children through a desperate desire to save them? Many families -- normal families by all the usual criteria -- have been driven to seizing their own children forcibly to extract them from cults and then exposing them to the intensive discussions of the cults' practices, including hard facts about the leadership, called "deprogramming.”

It has been estimated that two thirds or more of those who have been forcibly “deprogrammed” either never go back to the cults (even though they are free to do so usually in a matter of days or weeks) or return only temporarily. The remainder go back to stay (72). Often when they go back, the cult uses them to intimidate, or even to sue the family. A number of parents in the United States have been charged with kidnapping as a consequence of such failed rescue efforts. However, they are almost never convicted. When the question of criminal intent comes up, the jury rejects the kidnapping charge. Even so, there are the legal costs, the stress of the rescue mission itself, and the terrible subsequent harassment often experienced by the families. Clearly, in order to make such rescue missions and forcible deprogrammings unnecessary, other means should be available to deal with the matter of rescue. (see Removal above.)

B. Reentry Counseling

In the United States, reentry counseling (sometimes called voluntary deprogramming, or exit counseling) of people who leave the cults is a relatively effective, legal treatment approach. Most of these patients were not forcibly removed from a cult, but escaped, drifted out, or were ejected from the group, especially if they became ill. The whole question of reentry is something that should be on the conscience of society. What about cult members who do not have families to help them? What about the ones whose families are not sufficiently affluent to pay for reentry counseling services, and where charitable services (like Los Angeles's Cult Clinic) are not available? The problem is there; the seekers for help on reentry are there. Reentry counseling must be considered as a basic element in tertiary prevention. Here we find a neglected social responsibility.

C. Reconstitution of Relationships

This means working with the significant others in the life of the individual who is coming back into society. One of the few agencies that is truly providing this service in the United States is the Los Angeles Cult Clinic, which deals with families in a practical way (73). It helps them to keep lines of communication open to their relative in a cult, and productively deals with emotional aspects of the problem, thereby making it possible to reconstitute relationships when the cult member finally returns to the family.

D. Rehabilitation

This is an extensive, time-consuming process. The psychopathology of people coming out of cults has been described elsewhere (5). My rough estimate (based on observations not only of cult members but of people returning from prisoner-of-war camps, hostage ordeals, and other types of captivity situations that are similar) is that at least one-third will show some kind of obvious psychopathology. It may take several months before they are ready to work in something resembling ordinary psychotherapy. Prior to that, the method of group therapy employed by Singer (63) seems to be the most effective. Fully to rehabilitate some of these people will take a year or even more, as described by Goldberg and Goldberg (67). Society must be prepared to provide rehabilitation program for people who are seeking a return to normal productive lives. If treatment works, the taxes from these refunctioning people will more than pay for it afterwards. Without expert help many of them may become emotionally crippled public charges, or worse. An honorable and enlightened society cannot fail to provide such care.
Comment

Without apology, as a physician, I look at the cult problem with health and disease in mind. Many people in cults are at risk. Some are already sick. Some are dying. Some are dead. The stress upon their families generates additional casualties. A public health strategy is called for. It is my profound hope that such a strategy -- perhaps similar to the one here proposed -- will soon be put into effect. Great suffering might be prevented as a result.

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Acknowledgement

Except for minor changes, this article is reprinted from Cults and New Religious Movements (edited by Marc Galanter, M.D.), pages 165-192, published by the American Psychiatric Association, copyright 1989. Reprinted by permission.

Louis Jolyon West, M.D, Professor of Psychiatry, UCLA Neuropsychiatric Institute, has written widely on cult dissociation, hallucinations, alcoholism, and other subjects. For many years he directed UCLA's Neuropsychiatric Institute.