Lessons Learned: Therapy With Former Members of Cultic Groups or Relationships
ICSA Today, 13.1, 2022, 12-19
Lessons Learned: Therapy With Former Members of Cultic Groups or Relationships
By Lorna Goldberg
For about fifty years, I have been a therapist working with adults and children, and I specialize in seeing those who have left cultic groups or relationships. In this presentation, I address lessons I have learned from my clients, my colleagues, my therapist, and my ongoing education.
From the beginning, I have believed that we are enriched by openly listening to, considering, and incorporating new clinical insights whenever they appear to be accurate. I use a psychoanalytic approach that integrates newer theories and techniques. As a psychoanalyst, I see my task as making the unconscious conscious. As a therapist who works with trauma, I see my task as attempting to provide a safe therapeutic relationship to heal a traumatic past. As a therapist who works with former cult members, I usually see my task as lessening a harsh conscience.
To do our best as therapists, we need to keep learning. If being experts means we are finished products—perhaps even newer versions of all-knowing cult leaders—there are no experts. Our job isn’t to be right about clients. Instead of claiming to know clients’ minds, we view ourselves as experts in learning from and collaborating and coregulating with them. We are more useful when we see our role as helping clients develop new and more adaptive ways to know about themselves (Chused, Ellman, Renik, & Rothstein, 1999).
My introduction emphasizes my belief in openness to continued learning. I now will describe some of the essential lessons I’ve learned to help former cult members overcome cultic trauma and thrive. These lessons are the educational and experiential foundation of my work with former cult members.
Enter Your Own Therapy
The main goal of receiving therapy is to learn about one’s self and expand one’s sense of reality. That sense of reality expands by increasing awareness of the many ways in which the past contributes to one’s here-and-now experiences. Many of the difficulties we experience as humans were once adaptive solutions developed to protect us when we were confronted with life's early challenges (Shedler, 2006, p. 14). Problems arise when circumstances change, and early solutions and established patterns of behavior no longer work.
Through our own therapy as therapists, we learn that our assumptions can be incorrect or no longer helpful. We also learn how entrenched distorted thinking can be, and we can appreciate the fact that it takes time to change even when we wish to do so. As a result, we become more patient with clients, and we can resist quickly interpreting, intruding, patronizing, or intellectualizing their behaviors, which may have multiple meanings. These interferences can deter our clients from the personal growth that comes from gaining insights on their own.
As humans, we are all born vulnerable. Therapy helps us gain access to emotions that reside underneath our early adaptive solutions. We can view these solutions as our defense and coping mechanisms. After treatment, our enhanced understanding of our underlying vulnerability lessens a judgmental attitude and increases our empathy for others. As therapists, facing our pain helps us witness and tolerate our clients' painful and sometimes abusive experiences. Additionally, our own therapy helps us tune into ourselves and thus use our countertransference reactions to better understand our clients.
Some of our defenses can become longstanding character structures, developed in childhood to protect us and through which we try to gain love. Our personality traits and character defenses may work a good percentage of the time. Still, these fixed traits sometimes undermine our ability to react to life in the moment with flexibility and authenticity. The same is true of our clients. To survive and gain approval in the cult, former members have often unconsciously suppressed many of their idiosyncratic traits (precult traits or temperament style) and developed new ones.
Learn About Transference and Countertransference
Throughout my therapy, I experienced transference1 reactions toward my therapist as I brought feelings from the past into my relationship with him. My attitude changed over time, moving from occasionally viewing my therapist as a cold and demanding person to appreciating the fact that he reliably handled my strong reactions to him and thus attenuated my transference expectations. He always explored my reactions rather than shutting me down. His nondefensive behavior allowed me to gain insight into these misplaced expectations and, as a result, my own therapy allowed me later to feel more comfortable about the inevitable transference reactions of my clients.
Former cult members typically will repeat with the therapist their previous relationships with their cult leader(s) and also their parents. Those former members whose cult leaders or parents abused them, and as a result led them to believe that their expression of a variety of feelings was dangerous, may experience an array of “unacceptable” transference feelings toward their therapist (and others). The survival strategies former members employed in the cultic situation typically continue after they have exited. Thus, these clients might defend against feelings that they deem unacceptable through various responses (e.g., dissociation,2 silence, reaction formation,3 excessive pleasing, and self-punishing thoughts). As therapists, exploring these repetitions with them allows us to help clients become consciously aware of how their cult experience has influenced their way of relating and their expectations of others. For instance, transference will occur with clients even though we attempt to establish a relationship of respectful exploration that contrasts to the critical cult environment they experienced. They will also experience transference expectations with others in their postcult life (e.g., their bosses, loved ones, friends). However, to clarify, I don’t assume my client’s experience of me is all transference. Concurrently, I also explore how my unique personality might influence my client’s attitudes (Gill & Hoffman, 1982).
Exploration of our clients’ transference reactions improves their executive-functioning skills. Their self-awareness expands as they gain insight after looking at their underlying relationship expectations and understanding how the past has influenced these expectations. Therapy also helps clients gain insight into distorted beliefs they might have that may have led to self-defeating behaviors in the past. As an example, during therapy sessions Ruth typically discussed work rather than other activities in her life. As we explored this pattern, she shared her belief that I wanted her to work hard and not spend too much time “fooling around” with friends. In fact, Ruth had the belief that I would see her as “frivolous” when she was meeting her own desires. I asked her if I had said or done something to give her the impression that having fun with friends was frivolous. She was unable to point to my behavior. As we explored further, she came to see that she was transferring her cult leader’s attitudes onto me and undermining her healthy desires by projecting onto me cult-learned attitudes. Her expectation was that I would shame her for indulging in what her cult leader regarded as unworthy activities, and she was surprised when I encouraged her to have a balanced life.
As therapists, we also need to be aware of our countertransference4 reactions. We can learn about a client’s character traits through induced countertransference reactions. (By induced countertransference, I am referring to the emotional reactions we have to our clients, which every therapist would have.) A client’s character traits often appear when the client is defending against the spontaneous expression of emotion. By using our countertransference feelings to follow the character traits back to their origin, we discover the unconscious beliefs, memories, fantasies, and identifications of our clients.
For example, I was working with a couple from an esoteric cult. Rob, an intelligent man, spoke rather forcefully, and he used arcane vocabulary that was baffling to me. In response, I felt intimidated and began stumbling over words when I spoke. In my next session with them, when I addressed Rob’s behavior and my countertransference response, his wife, Barbara, laughed and said, “I never realized that Rob speaks exactly the way that our cult leader spoke!” Her husband laughed. However, at the same time, he was troubled. We explored how his character was reshaped because of his feeling overwhelmed by the leader’s endless lecture. Then we focused on Rob’s precult personality, which had been more relaxed and down to earth. If I hadn’t expressed my induced countertransference of feeling intimidated, we might never have discussed Rob’s defensive identification with his cult leader.
Enter Consultation or Supervision
Periodic consultation with or ongoing supervision by other therapists can help us be more effective in managing our and clients’ emotions and the therapeutic dilemmas we may encounter in the therapist-client relationship. This help can be particularly useful when we and our clients are pulled into an enactment—that is, an unconscious interaction based upon transferential/countertransference feelings that stem from both sides. Enactments often erupt when the client elicits a countertransference response from the therapist, or when the therapist’s countertransference elicits a transference reaction from the client (Chused, (2003).
Consultations and supervision encourage self-reflection. If we openly and nondefensively examine our part in enactments, both we and our clients can move on (Chused, 2003, p. 686). For example, after clients have experienced the boundary violations that typically occur in a cult environment, they need us to aid them in establishing firm boundaries. As a young therapist, my countertransference reaction to my clients was to play out the dyad of idealized rescuer and wounded client, stemming from a desire to compensate for my clients’ traumatic past. Through supervision and my own therapy, I discovered that in therapy with clients I was playing out a role I had played within my family in the past. In doing this, I was undermining my clients’ ability to use their cognitive abilities to the fullest. I also was preventing them from dealing with the realistic limits of relationships and the resulting negative (often transference) reactions. It is helpful for clients to recognize that ambivalence between love and hate is a part of every close relationship. It is constructive for our clients to see that we can survive their anger at us. At the same time, we want to challenge our client’s devaluation of us when that occurs.
Be Clear About Your Methods and Policies
Therapy shouldn’t be a mysterious process. In early sessions, to be open and transparent about the forthcoming therapy, I address with clients the mechanics of therapy, which includes my psychodynamic approach, the length of sessions, cancellation and vacation policy, and so on. I explain the concept of transference and potential transference issues. Additionally, because the cult structure can be perceived as authoritarian in style with a single worldview and with decision-making imposed from above, it is important for the therapist to establish a collaborative process with clients, with mutual acceptance and encouragement of different points of view.
Gain Specialized Training in the Cult Field and in Trauma
Cult-induced fears. Individuals’ cult fears (Hassan, 2018) continue into postcult life. In therapy, we help former members return to the source of their cult attitudes and distortions, to help them see when and how the cult leader first implanted them. For example, cult leaders demand nothing less than perfection. They thereby create a fear in members that the members are always being judged by others and found lacking. Therefore, former members might enter mainstream culture with cult-induced paranoia and an unrealistic notion that they should attain perfection in life.
Human fallibility. As a therapist, my belief in the fallibility of all humans helps to mitigate against this notion of infallibility. All of us will inevitably make mistakes. However, while newer therapists might attack themselves when they make mistakes, more experienced therapists usually learn that mistakes are inevitable, and they put their mistakes to good use. The worst thing in therapy is not to have made a mistake, but instead to become unable to acknowledge to ourselves that we have done so, or expose it to our clients, peers, supervisor, or therapist. That approach misses an opportunity for us to serve as a role model for our clients and reiterate that all human beings are flawed.
Depression. Clients who have been in a cultic environment are most often depressed. Their depression stems not only from the loss of a free life, but also, in part, from their having internalized the cult leader's and perhaps their parents’ attacks, which subsequently results in their developing a harsh conscience. As a result of their relationship with cult authority figures, former members are filled with shame and self-reproach. They usually believe that they were treated harshly because they were bad in some way. We need to learn about how former cult members struggle with a harsh or distorted moral code. We can help clients reevaluate their harsh self-assessment, which may be an incorporation of the cult leader’s demanding and unrealistic expectations.
Moral injury. Additionally, clients might be struggling with moral injury (Shay, J. 2014), the aftereffects of the cult's influence on their moral code. That is, after the cult, they typically feel distressed about cult actions they believe they initiated or were imposed from above. They now see this behavior as wrong. We can remind them of cult influence and explore their state of mind at the time of the cult behavior, and next, provide them with empathy. Thus, we will be setting the tone for helping clients become more compassionate and forgiving to themselves and others.
Cult-induced trauma. We need to educate ourselves about trauma and dissociation. For first-generation former cult members, cult trauma can be viewed as an "assault of the unimaginable" (Ringstrom, 2011, p. 550). A group that promised to be life enriching turned out to be a lie. I believe that we need to appreciate the life-changing impact of the cult experience and first deal with this trauma (for many) before we focus upon clients’ early childhood experiences. Those of you who are former cult members can understand from the inside the mixture of contradictory and overwhelming emotions unleashed after someone leaves a cult. First-generation former members wish to explore the radical change in their behavior and understand how the cult induced them to give up precult relationships, beliefs, interests, and their precult moral code.
For some former members, trauma can set the stage for them to repeat cultic experiences in ways that are harmful to themselves. For instance, former members can become vulnerable to controlling or abusive relationships. We need to explore with them how the past is repeated in the present.
Another response to trauma might be for former members to detach from others and the outer world. We can help by reflecting with them on how detachment might be related to some degree of dissociation, and, possibly, avoidance behavior that began in the cult. These behaviors served as protection in the past, but in the present, they can be undermining. We also can help clients consider new ways to master anxiety-producing situations by understanding them in the context of the past and learning to manage these emotions with grounding and relaxation techniques, and also self-care.
Education about cults. Cult education for clients first deconstructs the deceptive recruitment process to clarify what usually has been for them a mystifying, overwhelming, self-defeating, and often traumatic experience. Using an approach whereby the goal is to help clients better grasp the cult recruiting experience and, later, their early development before the cult, provides clients with a contrast between their behavior change resulting from undue influence and behavior that developed over time in their precult life.
Self-blame. Most former cult members, whether first generation or multigeneration, typically blame themselves, seeing themselves as stupid, flawed, or evil individuals because they incorporated the harsh attitudes of the cult. Even if they have chosen to leave, they might believe that they have failed or are doomed. As therapists, we can help by examining their incorporation of cult-instilled attitudes and fears, and we also can listen with a compassionate attitude that contrasts with cultic relationships.
Cognitive confusion. Cult members often protect themselves from the anxiety of cognitive confusion by defending against spontaneous emotions. Therefore, when former members leave the cult, many continue to show a dissociative gap. That is, after having suppressed their negative emotions or distress for so long, they can be unaware of the anxious, contrary, or angry feelings within their minds. It is our job to “mind the dissociative gap” (Bromberg, 2010). We help our clients to notice and gain access to those moments and the emotions that might have triggered a dissociative response.
In this way, we help first-generation former cult members form a bridge between the precult self and the cult self, or the protective outer self and the inner vulnerable self. As therapists, we can notice when our clients drift off, and we can explain their feelings of confusion from these disparities of thinking, handling them with kindness and understanding. This attitude helps former members begin to feel safe and thus reduces their anxiety so that they can gain awareness of inner emotions and accept contradictions of behavior without shame. In time, this process moves former members to an integrated, postcult sense of themselves (Bromberg, 2010).
Learn About the Specific Challenges Former Members Face
Treatment priorities. Often, therapists who work with people who became involved in cults as adults (first-generation adult former members) first will need to deal with the clients’ cult-related trauma before they focus on their early childhood experiences. In working with the increasing number of people born or raised in a cultic environment (second-generation [SGA] and multigeneration [MGA] adults), they will need to deal with after-effects in which the cult-related and childhood traumas may be inseparable.
Significance of a harsh environment. It is important for SGAs and MGAs to understand how the cult’s harsh authoritarian environment influenced their personality development. Because they don’t have a precult self to which they can refer. working out who they really are is often the most challenging task for them.
Complexities related to a harsh conscience. As mentioned earlier in general, another significant challenge for SGAs and MGAs is the development of a harsh conscience as the result of their having internalized the distorted moral demands of their environment. Working with a child who was raised in a cult provided me with heartbreaking insight into this cultic harm. Diana was an 8-year-old former cult member who had difficulty making school friends because she would tattle to her teacher about the misbehavior of classmates. She spoke in a way that indicated her superiority to her classmates because she was “good.” Her critical and superior-acting behavior appeared to be a defensive, learned behavior from the cult.
As we explored this behavior, I learned that, while she was in the cult, my client couldn’t help being “naughty” when she urinated in her bed nightly after being separated from her mother and brought to a cult school at the age of 5. When her bedwetting was detected, she would be pulled from the bed and forced to wash and dry her sheets before she could return to her bed. At times, she was put in a closet. My client was embarrassed by the bedwetting. Because symptoms usually have multiple meanings, I centered treatment on how her bedwetting might have been how she expressed her frightened, sad, angry, and shamed emotions arising from her own harsh judgment of herself. She defended against and protected these underlying feelings by an outer character style that identified with the aggressor’s harsh and superior attitude (Goldberg, 2011).
Prolonged stress and C-PTSD. Many SGA and MGA former cult members who have experienced early prolonged stress might display neural compromises and impacted nervous system reactions in all areas of development, which often results in Complex PTSD (C-PTSD), or relational trauma. In recent years, I have found it edifying to learn how a positive relationship or psychotherapy can change the brain and nervous system by building new neural (Schore, 2006) and emotional connections (Porges, 2011). I’ve come to better appreciate how therapy needs to rest upon the foundation of the relationship. We need to use the therapeutic relationship to address undermining beliefs, increase clients’ trust, and enhance their capacity for mentalization—the capability to understand mental states within themselves and others.
For example, some of my clients as adolescents were placed in abusive, cult-like, drug-treatment programs. In what has been called “the troubled teen industry,” these clients experienced the kind of extreme, abusive behavior depicted in the novel Lord of the Flies at a time when their brains still were developing. That experience left many survivors with poor ability to regulate emotions. They also tended to incorporate their abusers’ negative view of them into their opinion of themselves. It appears that both their dysregulated state and the self-hatred that stems from endless attacks might be connected to the high rate of suicide among survivors of the teen programs. It is helpful for them to be in therapy with a hopeful and reliable therapist who tackles their sense of shame and challenges any expectations they might have of a bleak and foreshortened future. In addition to the enhanced mentalization that occurs through talk therapy, when therapists incorporate awareness of somatic responses, these individuals typically can be aided by attention paid to self-care, relaxation techniques, medication, and physical activities.
Repetition of trauma. For many clients, intrusive repetition of trauma can occur. These repetitions also can occur through flashbacks, nightmares, somatic reactions, and painful memories. After they have been prevented from expressing genuine feelings, former cult members can be plagued with painful somatic reactions such as migraines, muscle aches, and stomach disorders. Some of these reactions also might stem from cult predictions they endured about what would happen to them once they left (i.e., their body would rot, or they would get cancer).
For example, Susan, an artist, would suffer from stomach problems whenever she attempted to create art. Her physical symptoms lessened as she became more aware of how her symptoms contained emotions that she found difficult to face. In time, she became in touch with her previously unconscious fear of attack if she went against the cult’s prohibition against “showing off.” When she was a child, Susan loved to draw; but her cult devalued her drawing, punishing her for her “scribbles.” Getting in touch with her underlying cult-instilled fear allowed her to move ahead with her projects more freely.
SGA and MGA experiences. In contrast to first-generation former members, the early childhood experience and the cult experience are the same for SGAs and MGAs. Therapists need to appreciate how the cultic past is integral to SGAs’ and MGAs’ sense of self. Specific character traits and defenses, often in some dissociated form, will preserve the past experiences of former cult members (Goldberg, 2006). During their early social, emotional, and academic development, these former members have been raised in a culture defined by the predilections and abusive practices of the narcissistic and often antisocial leader. As a result, the initial traumatic experiences of these individuals become locked in place and, when triggered by a reminder of trauma, the same action will be activated, and there will be a reaction that echoes their response to the trauma. This response causes the feeling within the individuals that they are reliving the event (van der Kolk, 2014).
Learn About Posttraumatic Growth
We need to help former cult members consider their strengths that have resulted from trauma that have led to their posttraumatic resilience and growth. They have demonstrated enormous courage in leaving their situation despite numerous fears of the outside world instilled in them by the cultic group, and the potential loss of familiar relationships. Former cult members’ ability to survive their cultic experiences can lead to confidence they can draw upon to get through future difficulties. Many former members continue to be idealistic and display great compassion for others who have suffered. Once they understand the effects of their cult experiences, most have used their inherent skills to flourish, both emotionally and economically, in postcult life.
Enjoy Being a Therapist
Finally, it helps not only to be humble, but also not to take yourself too seriously. Laughter is a crucial part of therapy. Laughing at ourselves rather than mocking others contrasts with the cult leader’s cruel, paranoid world. Laughing is liberating and can soften a harsh conscience.
As a therapist, I have a long view of therapy. Sometimes it takes a great deal of time for change to occur; but along the way, it can be incredibly rewarding to see our clients grow and succeed. Therapy helps former cult members tolerate their uncomfortable feelings and feel more confident about their ability to manage their lives.
 Transference: “The displacement of patterns of feelings and behavior, originally experienced with significant figures of one’s childhood, to individuals in one’s current relationships” (Moore and Fine, p. 92).
 Dissociation “is the isolation of elements of experience from each other that decreases coherence, increases a sense of fragmentation, and precludes the possibility of making accurate sense out of perception of self and world” (Chefetz, 2017, p. 84).
 Reaction formation “is concerned with antitheses; it is the replacement of a wish with its opposite. For example, an exaggerated cleanliness replaces an interest in dirtying, while exaggerated kindness and politeness obscure an intolerable sadism and aggression” (Mollinger, p. 469).
 Countertransference originally was defined as a situation in which a therapist’s feelings and attitudes toward a client stem from feelings the therapist has derived from situations in the past and is now displacing onto the patient (Moore & Fine, 1990, p. 26). Heiman expanded this definition to focus upon how the analyst’s emotional response to his patient becomes a significant pointer to the patient’s unconscious processes and guides the analyst toward fuller understanding of the patient (Heimann, 1950, p. 83). Therefore, instead of something analysts must overcome, Heiman viewed countertransference as a tool therapists can use to better understand their patients (Heiman, 1950). A more contemporary approach suggests that we should analyze transference and countertransference as a mutual interactional process instead of each aspect becoming artificially split off from the other, as if each occurs in isolation (Aron, 1991, p. 33).
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About the Author
Lorna Goldberg, LCSW, PsyA, board member and past president of ICSA, is a psychoanalyst in private practice and Director at the Institute for Psychoanalytic Studies. In 1976, she and her husband, William Goldberg, began facilitating a support group for former cult members that continues to meet monthly in their home in Englewood, New Jersey. Lorna and Bill received the Hall of Fame Award from the authentic Cult Awareness Network in 1989 and the Leo J. Ryan Award from the Leo J. Ryan Foundation in 1999. In 2009, Lorna received the Margaret T. Singer Award from ICSA. Along with Rosanne Henry, she cochaired ICSA’s Mental Health Committee from 2003 to 2008. Lorna has published numerous articles about her therapeutic work with former cult members in professional journals, including, in 2012, “Influence of a Charismatic Antisocial Cult Leader: Psychotherapy With an Ex-Cultist Prosecuted for Criminal Behavior,” International Journal of Cultic Studies, Vol. 2, pp. 15–24. She cowrote with Bill Goldberg the chapter “Psychotherapy with Targeted Parents” in the book Working With Alienated Children and Families (2013), edited by Amy J. L. Baker and Richard Sauber. In 2018, at the International Cultic Studies Association’s Annual Conference, Philadelphia, Lorna presented the plenary address, We Disagree—Let’s Talk! Why Diversity and Dialogue Are Necessary and How We Overcome Undermining Factors.