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Satanic Ritual Abuse: Principles of Treatment
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by Colin A. Ross, M.D.



  1. Secret Societies Throughout History
  2. Psychology and History of Satan
  3. The Malleus Maleficarumand the Catholic Inquisition
  4. Non-Satanic Cult Activity in North America


  1. Five Levels of Satanism
  2. Satanism and Multiple Personality Disorder
  3. Alternative Hypotheses of Ritual Abuse


  1. How to Recognize Satanic Ritual Abuse Survivors
  2. General Principles of Survivor Therapy
  3. Special Techniques for Satanic Ritual Abuse Survivors


  1. Extremes of Skepticism and Denial
  2. Future Directions
  3. Afterword by Elizabeth F. Loftus, Ph.D., University of Washington


Satanic ritual abuse was a topic unknown to most people in North America as recently as ten years ago. Since then Satanic cults have been the subject of countless media reports, of which about five hundred are listed in a bibliography by Linda O. Blood entitled Satanism and Satanism-Related Crime: A Resource Guide (1989). When I saw my first case of apparent Satanic ritual abuse in 1986, I had never read a book or article on the topic heard any mental-health professional mention such a case or been to a lecture, workshop, or seminar on the subject. Since then, two academic collections of essays on Satanic ritual abuse have been published (Richardson, Bromley, and Best, 1991 Sakheim and Devine, 1992), the Journal of Psychology and Theology has devoted a special 1992 issue to Satanism, the Journal of Psychohistoryhas devoted a special 1994 issue to cult abuse of children, and The New Yorker has published a major two-part article on Satanism, in the 17 and 24 May 1993 issues (Wright, 1993a 1993b). Additionally, dozens of conferences and workshops dealing with Satanic ritual abuse have been held throughout the United States and Canada.

Personally, I have had clinical contact with about three hundred cases of multiple personality disorder (MPD), now officially renamed 'dissociative identity disorder' (American Psychiatric Association, 1994), in which the person had memories of involvement in a destructive Satanic cult. In about eighty of these cases, I have had considerable direct involvement, as a therapist or attending physician, and in the rest I have been a participant in consultation or in group therapy. In none of these cases has the reality of the memories been objectively verified, and in several of them collateral history has proven that patient claims of Satanic ritual abuse were false. I did not seek verification beyond the level of usual clinical history-taking because that is not my role and because I have not had the available resources or expertise. The patients cite the remoteness of the events in time, fear, and lack of resources as the reasons for not pursuing objective verification of their memories.

In order to understand this troublesome topic better, I began attending workshops on Satanism and talking to colleagues I also began to read the available literature, and noticed that it had several peculiarities I had never before encountered in my professional reading. For one thing, as is evident from the references in this book, the literature on Satanic ritual abuse comprises more books than journal articles. Usually, in the professional literature dealing with mental-health subject areas, the reverse is true - articles far outnumber published books.

The second peculiarity I noticed, both at professional meetings and in my reading, was an extreme polarization of opinion. Despite the dearth of scientific or empirical literature, strongly worded views were expressed at both ends of the continuum, which ranged between firm belief in the reality of Satanic ritual abuse memories and skepticism about the truth of any of those memories. The reality of Satanic ritual abuse did not appear to be a subject of debate in any serious sense, and seemed, rather, to involve believers and skeptics speaking from preconceived, ideologically driven positions. Discussion focused on whether such cults really exist, which is a reasonable starting point, but had no context and seemed to be conducted in a historical, anthropological, clinical, and law-enforcement vacuum, with little or no organized data to provide a foundation.

The books I read tended to fall into one of four categories: case-studies (Feldman, 1993 Marron, 1988 Mayer, 1991 Smith and Pazder, 1980 Spencer, 1989 Stratford, 1988 Terry, 1987 Warnke, 1972 Wright, 1994) books written from a fundamentalist perspective (Brown, 1987 Bubeck, 1991 Cooper, 1990 Larson, 1989 Michaelson, 1989 Passantino and Passantino, 1991 Schwarz and Empey, 1988) or a twelve-step perspective (Ryder, 1992) and journalistic treatments (Blood, 1994 Hicks, 1991 Johnston, 1989 Kahaner, 1988 Lyon, 1988).

Although these books contain a great deal of useful information, they are limited in so far as they discuss a small number of cases from a single-case perspective or tend to be contaminated by the ideological biases of their authors. In none of this literature did I find a comprehensive context for thinking about the problem of Satanism. Realizing that an adequate discussion would have to be grounded in detailed knowledge of the clinical reality of ritual abuse cases, I sought in vain for a comprehensive study of such cases. The case descriptions tended to be brief, vague, or skewed by the biases of the authors, and none exhibited adequate psychological depth.

Similarly, in searching for a book that placed Satanic ritual abuse in a historical context and provided scholarly discussion of the history of known destructive and human-sacrifice cults, and secret societies, I found no single work that contained what I was looking for. Additionally, I was unable to locate a history of Satan that brought theological and cultural knowledge to bear on discussions of contemporary Satanism. It seemed to me that several indispensable contexts were absent from much of the discussion of Satanic ritual abuse, and that, without these contexts, the ungrounded, unprofitable, and polarized debate was likely to continue. Finally, and most important for my clinical work, no sufficiently detailed discussion of how clinicians can treat Satanic ritual abuse cases was available in the literature.

In deciding to write this book, I saw the necessity of correcting the contextual deficiencies but was also aware that I am not qualified as a theologian, historian, expert on non-Satanic cults, or anthropologist to the degree that is required for the task. Dealing adequately with the complex subject matter in the first section of this book would require a Ph.D. in three or four different disciplines, an achievement far beyond the grasp of any single individual. Nevertheless, background reading completed, I set out to write a book that would provide a context sufficient for the clinician's needs. I try to do one main thing in this book: to establish that good clinical work requires a balanced perspective, free of the limitations imposed by adherence to either end of the ideological continuum. Such a perspective acknowledges that, while there is no evidence of a widespread secret network of Satanic ritual abuse, it is possible that a certain percentage of Satanic ritual abuse memories are historically accurate, or contain accurate elements.

Within the limitations of our current knowledge, no one can measure with any factual accuracy the extent of organized Satanism. It is my opinion that many of the Satanic ritual abuse memories described by the patients I treat are confabulated and comprise things that never actually happened. However, I am cautious in this opinion because I cannot know for sure that it is correct. I assume, for the sake of discussion, that 10 percent of the content of such memories could be historically accurate and based on distorted recall of childhood participation in small Christian cults small, isolated groups of Satanists deviant elements of the Ku Klux Klan pornography or other forms of abuse that a child could misinterpret as Satanic.

In this book, I describe a treatment method for Satanic ritual abuse survivors with MPD in which the interventions can be used regardless of what percentage of the memories are real. Satanic Ritual Abuse has a clinical focus, and the necessary non-clinical background it provides is unavoidably incomplete. Writers from other disciplines should consider producing scholarly works on the history and anthropology of Satanism and destructive cults that would adequately explore the material reviewed in the first section of this book.

The objective reality of Satanic ritual abuse memories is primarily a sociological and law-enforcement question and cannot be answered by clinicians. Nonetheless, clinicians treating this population need guidelines that will encourage grounded, helpful therapeutic interventions, free from the extremes of belief and skepticism. To this end, Satanic Ritual Abuseendeavours to reduce the unproductive polarization of debate about Satanism within the mental-health field, and in society, at large, by criticizing both extremes to provide a wider context for discussion to suggest specific research studies that are required to correct key conceptual errors in the field and to describe the clinical reality of Satanic ritual abuse cases.

In this book, I provide clinicians with guidelines for how to recognize and treat such cases. Because my clinical experience is limited almost entirely to Satanic ritual abuse survivors with MPD, I deal predominantly with those patients. This focus is consistent with clinical needs because most patients who report such memories have MPD. (I use the abbreviation 'MPD' in this book, rather than the new term 'dissociative identity disorder,' because the former term is still more familiar to most readers.) However, the clinical focus also addresses the broader debate, establishing a context that is too often absent or distorted by misinformation. In describing a balanced clinical treatment of Satanic ritual abuse cases, the clinical material creates a way of understanding and treating these cases that can be effective regardless of what percentage of the memories are real, and this strategy also reduces the polarization into opposing camps of believers and skeptics.

Throughout this book, I set contemporary Satanic ritual abuse in a context of Judaeo-Christian culture: my perspective on Satanism is rooted in themes of dissociation, dualism, and projection, which are at the heart of our history and which are within my expertise as a psychiatrist. I see the sociology of the controversy surrounding Satanic ritual abuse as a contemporary enactment of the myth of Satan, which is the deepest myth of Judaeo-Christian culture.

The question of the extent to which the symbolism and mythology of Satan are being acted out in Satanic human sacrifices in North America in the late twentieth century is not answered in these pages, and cannot be. As I said earlier, at least 10 percent of the reported memories could be real: no one knows where the actual figure falls, and no benefit can be derived from making premature estimates. Similarly, no attempt is made in this book to produce a formal definition of Satanic ritual abuse. There are too many forms and levels of Satanism for one definition to be all-encompassing, and, when it comes to the most extreme form of Satanism - multigenerational orthodox Satanic cults - it is clear what we are talking about. These cults, if they exist, are secret, highly organized, and devoted to human and animal sacrifice, sado-masochistic ritual sex, child abuse, and other crimes, which are committed during ceremonies involving pentagrams, robes, chanting, Satanic theology, candles, goblets, daggers, and other paraphernalia.

As initial reading about Satanic ritual abuse, I recommend The Satanism Scare (Richardson, Best, and Bromley, 1991), because I find it to be the best collection of essays written from a skeptical viewpoint, and Out of Darkness: Exploring Satanism and Ritual Abuse (Sakheim and Devine, 1992), which is the best collection of essays from a believer perspective. For law-enforcement information and a governmental perspective, I recommend Satanism and Occult-Related Violence: What You Should Know (Langone and Blood, 1990) Report of the Virginia State Crime Commission Task Force Study of Ritual Crime (Gray, 1992) the Office of Criminal Justice Planning, State of California, Research Update6/1 (Winter 1989-90) and the report on Satanic crime prepared by Kenneth Lanning of the FBI, entitled Investigator's Guide to Allegations of Ritual Child Abuse, (1992). Information for ordering these materials is provided in chapter 12.

Special issues of three academic journals contain papers on Satanic ritual abuse: Journal of Psychology and Theology, 20 (1992) Child Abuse and Neglect, 15 (1991) and the Journal of Psychohistory, 21 (1994). Academic papers by Ofshe (1992) and Nurcombe and Unutzer (1991), and the paper by Young, Sachs, Braun, and Watkins (1991) are worthy of attention, as is a popular article by Whitley (1991).

Those who are skeptical that Satanic ritual abuse could be real should read Dzeich and Schudson's book on how U.S. courts deal with child sexual abuse, entitled On Trial: America's Courts and Their Treatment Of Sexually Abused Children(1991). Dzeich and Schudson describe a non-Satanic case which resulted in conviction. The Country Walk case from Miami, Florida, resulted in a prison sentence without chance of parole until the year 2150 for Frank Fuster. Dzeich and Schudson write: 'The victims, predominantly infants, toddlers, and preschoolers, were subjected to sexual abuse and pornography to being drugged and terrorized by sadistic games, disguises, and animal slaughter and to having to drink urine and consume excrement. Authorities estimated the couple [Frank and Iliana Fuster] had access to as many as fifty children but by the time the case reached court, only eight were able or permitted by parents to testify' (p. 78). Fuster's wife corroborated the children's stories under oath.

The fact that Frank Fuster was convicted for acts that include all the alleged activities of Satanists except human sacrifice proves that such acts can take place and have occurred in North America in recent years. Though there is no evidence that he belonged to an organized cult, Frank Fuster had prior convictions for murder and child molestation, though these facts were not admissible in court and not known to the jury.

Other media sources provide hints but no proof that actual Satanic ritual abuse may be occurring in the Western world today. An article in The International Herald Tribune, 30 December 1993 (Anastasi, 1993 Blood, 1994), describes the arrest of a group of Satanists in Greece. Four soldiers in their twenties and an eighteen year old woman confessed to the ritual murder of two humans during Satanic ceremonies: the victims were a fourteen year old girl and a twenty-seven year old woman. According to the charges, the group carried out 'rituals in tribute to a satanic god, rituals that mostly involved drinking and sex orgies. They would then restrain their victims with chains and handcuffs, torture them, and in two cases put them to death with daggers and a gun.' The arrests occurred because one of four girls being prepared for sacrifice on 25 December 1993 'broke down and reported the rituals to police.'

Although this case has not yet gone to trial, charges include premeditated murder, torture, conspiracy, arson, and illegal possession of firearms. Depending on its outcome, this case suggests that some memories reported by Satanic ritual abuse survivors in treatment in North America could be real.

In their book Missing Children: Rhetoric and Reality, Forst and Blomquist (1991) review the statistics on missing children in North America. The authors' intention is to counter the fear that thousands of children go missing every year in the United States although they are committed to the view that the number of cases per year indicates that the problem is not widespread, and their bias is against hysteria or exaggeration, their figures are none the less alarming.

In 1983, the U.S. Department of Health and Human Services estimated the number of missing children in the United States at 1.5 million a year. The vast majority of these children were only technically missing, since they returned home within a few hours or days, with or without police assistance. A disparity in estimates is apparent within the narrower category of kidnapping: in 1985, the executive director of the National Center for Missing and Exploited Children estimated that between 4,000 and 20,000 children are kidnapped by strangers in the United States per year in 1981, the FBI investigated only 35 child kidnappings, and, in 1986, only 57 cases. We have no precise accounting of the number of children who go missing permanently in North America per year.

The National Statistical Survey of Runaway Youth estimated that 733,000 youth ran away from home in the United States in 1975, and the figure was set at one million per year by the commissioner for the Administration of Children, Youth, and Families in testimony before a U.S. Senate subcommittee in 1990.

In contrast to the number of children who potentially could be kidnapped into multigenerational orthodox Satanic cults is the figure of confirmed cases of children having been kidnapped and murdered by a stranger in the United States: this figure ranges between 52 and 156 children per year, according to Forst and Blomquist - conservatively, about 5,000 children since the end of the Second World War. The figure the authors derive for the percentage of kidnapped and missing children who are murdered is 2.8 per cent, a remarkably precise estimate, given the amount of noise in the data.

Forst and Blomquist describe the study from which the estimate of 2.8 per cent is derived: the study was done in Jacksonville and Houston and examined 1,299 cases of child kidnapping by non-family members in those two cities, as detailed in the 1986 report of the National Center for Missing and Exploited Children. Inexplicably, only 211 cases were included in police records, but of these 211, 54 per cent involved sexual assault, and 2.8 per cent murder.

If the 211 cases in police records were a representative sample of the 1,299 cases, then 36 children were kidnapped and murdered by strangers in two U.S. cities in one year, compared with a total of 57 kidnappings with all outcomes investigated by the FBI in the entire country in 1981. One must conclude from these figures that estimates of the number of children who are kidnapped and murdered per year in North America are imprecise by extension, one could also conclude that it is logistically possible for a number of undetected ritual murders to be conducted per year in North America.