This article aims to address the most commonly used therapeutic skills and techniques when working with members belonging to high control groups (cults). Mental health practitioners need to be aware of the harmful psychological issues current and ex-cult members continue to show even after they leave such an organization. Individuals who have become part of these restrictive religious groups generally suffer from rigid thinking patterns, feelings of guilt, shame and a sense of abandonment. Mental illness and substance abuse are also commonly observed. Suicidal tendencies, PTSD, anxiety and depression are just some of the grievances that these clients endure. Psychologists, LCSWs, LMFTs and LMHCs can utilize a variety of approaches when working with this population. Most researchers agree that educating clients on the cult’s history and destructive practices is the building block and lays the foundation of their recovery.
Introduction to the problem
Religious cults, also known as new religious movements (NRM), have had a consistent presence over the past 100 years. Generally, when the word cult is mentioned, people envision scenes of the Jonestown massacre, mass weddings, polygamy marriages or individuals living in segregated communities. Not all destructive cults are so dramatic. The loss of free will, commonly called brainwashing, is generally used to explain why members choose to remain in such high control groups. Destructive cults often require their rank-and-file members to donate the majority, if not all of their time, effort and money to the group’s purpose. It is not unheard of for cult members to slowly or abruptly discontinue association with their family and friends. Cult leaders use a number of deceptive practices in order to convince their audience that the mission and vision of the group is paramount and that everyone not showing adherence to it is an opposer. A member’s previous social circle is viewed as a threat since family and friends could potentially persuade their loved one to stop attending the cult’s activities. Hence, it is not surprising that rank-and-file members are encouraged to minimize their interactions and lines of communication with any non-cult members.
The more time an individual spends with cult members, the more indoctrinated they become and the stronger their belief that the cult’s leadership has answers to all life’s questions. By cutting ties with former friends and family, the social support that a member now has is exclusively formed by other cult members. Together, members of high control religious groups consistently reinforce the cult-like mentality amongst one another. Often, cult leadership expects the rank-and-file members to report any “suspicious”, unpermitted activities by other members.
Learning about cults, their methods, tactics and internal practices is of relevance today more than ever. About 3 years ago, a documentary aired by the Oscar winning producer Alex Gibney made all the headlines both on social media and major TV networks. The documentary, “Going Clear: Scientology and the Prison of Belief” shows several interviews with high executive Scientology members who were either “kicked out “or left the group on their own. As interesting as this documentary may be, it’s true value was bringing awareness to the general public that any individual, regardless of their history, social status, race and gender, can be a potential victim to such groups and movements.
It is imperative for mental health practitioners to be able to discern the underlying issues and experiences that clients from high control groups have had. Research has shown that active and ex-members suffer from mental illness, substance abuse and co-morbid disorders. Among the many psychiatric diagnosis, the most frequent symptom is disassociation, also called “floating” (Coates, 2010). Additionally, PTSD, anxiety, depression, destructive and suicidal tendencies are also commonly diagnosed (Coates, 2010). Many of the individuals who were either “kicked out”, left on their own or have become inactive, have a difficult time opening up and sharing their experiences. Feelings of guilt, shame and abandonment from their formal cult-family remain even after leaving the group.
Interventions
The psychological literature is overwhelmingly united in comparing cult members’ experiences to those of concentration camp survivors and former POWs (Coates, 2010). Due to years of indoctrination and brainwashing, members of high control groups remain psychologically scarred for many years after leaving a cult. Members are explicitly forbidden to watch, read or discuss information critical to the group (Walsh, 2001). Living in a cult enforces members to internalize their problems. For those associated with Bible-based cults, the line of thinking is that if members are feeling down and depressed, this must be undoubtedly due to the fact that they are not spiritual enough. Consequently, members force themselves to outdo other members’ performance in hopes of becoming more spiritual and achieve the promised happiness. Unfortunately, these activities only tend to reinforce the cult-identity and cult-like mentality.
The experience of rigid thinking (black and white terms), the inability to make decisions, issues with relationships as well as feelings of self-blame, guilt and shame all require a specific type of treatment. Psychotherapists have two roles when dealing with clients who hold harmful religious beliefs: understanding the clients’ problems and identifying effective treatment methods (Rosenfeld, 2010). Additionally, therapists must be confident that their clients have enough motivation and social support to cope with the potential loss they may endure if they were to leave the cult (Rosenfeld, 2010). A common treatment intervention for psychotherapists to follow is to encourage clients to critically evaluate the beliefs they had acquired during their early childhood. This is especially true for those born in cults who have never had the chance to examine their religion or have never had access to a different religious belief. Motivational interviewing is instrumental since a cult member would attempt to explore their beliefs objectively (Miller & Rollnick, 2002). Moreover, neutrally reviewing previously held beliefs with other alternative beliefs allows the member to compare their religion to those of others and see similarities.
For some, leaving a cult is associated with freedom, a new chance in life and the possibility to make personal decisions on their own. Others however, feel overwhelmed, lost and cut off from the life they had built while in the cult. In many situations, members have had to give up communication with their spouses, children, grandchildren, cousins, nephews, nieces, uncles, aunts and friends. For those who have chosen to leave on their own, the cult leadership shows their leaving as a sign of disloyalty to the “true organization”. Any remaining cult members are required to discontinue all association with them.
Another treatment method involves psychodynamic therapy. This theory is especially useful when dealing with Jehovah’s Witnesses’ clients (Friedson, 2015). The role of the therapist within the psychodynamic approach is to reach out to the client’s unconsciousness and promote exploration. By doing this, individuals’ inner world, where dreams, fantasies, fears and wishes as well as personal relationships exist provides the opportunity to begin work towards recovery. Other important tactics which contribute to successful psychodynamic treatment are mirroring, validating client’s feelings in addition to assisting members to recreate a narrative of their lives which may otherwise be too overwhelming to achieve on their own (Friedson, 2015). Being in this therapeutic relationship with clients and showing consistency is something new, unknown and different from what they have been accustom to in their cult lives. Hence, building a therapeutic relationship is of utmost importance in addition to validating the clients’ experiences. Although many psychodynamic therapists would prefer to focus on the cause rather than the symptoms, this does not suggest that they are unconcerned with the current difficulties that a client may be experiencing. Often, clients are unaware of what lies underneath. Treating patients from high control groups with the methods of psychodynamic theory implies that professionals look for the broader picture and context along with any underlying issues.
Exit counseling is the preferred choice of treatment according to Sirkin (1990). In order to successfully treat a cult member, counselors must be able to take an in-depth, effective assessment. “Unlike most other difficulties for which psychotherapy is sought, the cult-involved individual usually feels that they have no problems; rather, the family members and others who object to the involvement are in need of assistance” (Sirkin, 1990). There’s a lot of work needed to be done prior to the actual individual session with the person involved in a cult. An ideal option would include counseling sessions with both the involved individual and his/hers family. Loved ones who have already been indoctrinated and living in the cult for years are often perceived by their family as having bizarre behavior. Thus, therapists’ roles are to educate the family that blaming statements and judgmental behaviors are not beneficial. On the contrary, they will surely reinforce the cult mentality that indeed, family members do act as opposers.
Family therapy sessions are helpful since they assist to open lines of communication with cult members. If parents haven’t heard from their loved ones then a counselor or a therapist could suggest that they write letters, send emails and pictures to remind the cult member that people still deeply love and care about them. Once communication with the family is restored and the relationship between members is consistent, then individual therapy may begin. Therapists are encouraged to assess the person’s pre-cult identity. By asking questions of who they were and what they enjoyed doing prior to joining the cult, members are reminded of long forgotten activities, of a different life. What is often found during therapy is that cult members have limited or absolutely no knowledge of the cult’s history and leadership’ practices (Sirkin, 1990). The actual individual exit counseling process may take anywhere from several hours to several days. Individual and family therapy as modalities complement one another and are used to build a consistent and stable rapport not only between a therapist and client, but also between each member in the family unit.
There has not been a lot of research done with second and third generation cult members. When working with this population, researchers suggest to utilize a constructivist, social justice, grounded theory approach in order to examine how clients have built the world they now live in (Matthews and Salazar, 2014). Initially, counselors are to educate themselves about cult and cult recovery. The next step would be to assess the client’s personal cult experiences and to help them critically evaluate the nature of their cult along with its power dynamics. As the therapeutic process progresses, clients are encouraged to review the effects of growing up in a cult. New skills are taught such as deep breathing techniques, relaxation and visualization. By the end of therapy, clients are empowered to take control of their lives as well as to advocate and empower others (Matthews & Salazar, 2014).
Implications for Therapists
Counselors working with former and current cult members need to be educated when working with this population. Being informed and well-trained with the skills and techniques needed in order to assist these clients is imperative. Many struggle treating individuals coming from Bible-based as well as non-religious high control groups. For a number of years some scholars have argued that religious and spiritual matters are reserved territory for pastors and spiritual leaders and should be treated separately from psychotherapy (Rosenberg, 2010). However, mental illness is closely connected with clients’ spiritual life. Nowadays, more and more therapists consider an individual’s spiritual beliefs as a piece of the puzzle, in order to achieve client’s overall well-being. Discussing religion and spirituality during sessions could be used as a building block. To separate them from the therapeutic process could be detrimental for clients.
There is a growing awareness of cults and their practices since more and more ex-cult members are going public and sharing their personal stories and experiences. This allows mental health counselors the ability to gather a lot of information in a relatively short time. However, more studies need to be conducted in order for researchers to develop a deeper understanding when treating these clients. Generally, cult members are not very open in participating in studies due to feeling afraid and of being ridiculed (Coates, 2010).
Lastly, therapists need to be mindful when working with families prior to meeting their loved ones. They may feel tempted to ally with the family, especially knowing that high control groups use unethical practices.
Final Note
The interventions discussed in this article followed psychodynamic theory, client-centered therapy, interventions based on cognitive-behavioral therapy and constructivist grounded theory. When using these theories and intervention psychologists and therapists must remember that even if the intervention was not effective at this moment and thus, the individual remains in the cult, the seed has been planted potentially making it easier to leave at a later time. Although this can be heartbreaking for family members, sometimes the timing is just as important as the intervention itself. Overall, building rapport and psychoeducation has shown to be most effective when dealing with this population. As destructive as high control groups can be, individuals need to be aware that there is hope and that they can overcome a cult experience. On the other hand, counselors and therapists must not be weary and afraid of addressing people’s spiritual and religious experiences especially if it’s detrimental to their clients.
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