- Satanic abuse; Body And Mind

 Satanic abuse does not exist. This is the leaked finding of a three-year inquiry commissioned by the Department of Health, chaired by Jean La Fontaine, a social anthropologist of the London School of Economics, and to be published shortly. Satanic abuse thus joins other episodes of false collective beliefs in the psychiatric literature.

  I was an agnostic on this issue until I read Treating Survivors of Satanist Abuse (Routledge) edited by Valerie Sinason, a child psychotherapist at the Tavistock Clinic in London. This converted me from agnosticism to frank scepticism. Why did it so singularly fail to convince me? The chapter on satanic cult practices claimed the existence of a complex social structure of satanic abusers. This consists of prominent people, including police, doctors, aristocrats, politicians and ambassadors. They are grouped into circles or lodges, complete with scribes,disciples and thanes. Commanders, the leaders of the cults, meet regularly at conference centres and hotels, to plan policy.

 What do they do? They enact satanic ceremonies in special temples, which involve a variety of ritual objects, such as altars, skulls, and stuffed goats' heads. Insects, spiders, frogs and snakes play a prominent part. However, all equipment is immediately removed should any police or social workers come near, hence none has ever been discovered. At these ceremonies human sacrifice takes place, including foetuses, the children of cultists, runaway children, vagrants or illegal immigrants. Children routinely eat the flesh, which is then burnt, hence no bodies are ever found. Sometimes fellow cultists who have transgressed are sacrificed.

  A case history is given of a four-year-old, kept naked in an underground room for weeks at a time. Her only companion was a freshly sacrificed corpse, whom she was expected to eat for nourishment. Children are coerced into silence by conditioning and brainwashing, so that apparently innocuous toys, cards or letters convey satanic warnings. Hence social workers in Orkney insisted that the children thought to be victims of satanic abuse should receive no messages or presents from their families. The chapter concluded with a list of satanic holidays, and an injunction on therapists not to take leave on these days.

 These stories are reminiscent of another modern fantasy the growing number of people who claim to be abducted by aliens. These experiences also occurred in states of altered consciousness (in satanic stories usually ascribed to the drinking of drugged orange juice). These victims also needed encouragement, sometimes from hypnosis, to remember their abuse. Some of the apparatus is similar both report surgical operations and wires attached to the skull. The descriptions of the cultists, with their cloaks, masks, hoods and so on, come from our horror tradition, just as the stereotyped aliens come from science fiction.

  Some of these stories sound like schizophrenic delusions, or delusional memories. The book acknowledges that some victims describe delusions and hallucinations that would otherwise be evidence of schizophrenia, except that the patients didn't ``feel schizophrenic''.

  Sad though these stories are, saddest of all is the way in which well-meaning professionals have become caught up in them. Few of these memories have emerged fully formed: they need to be coaxed out of the victim.  Dr Gill Mezey, consultant forensic psychiatrist at St George's Hospital, is an active campaigner for the recognition of child sexual abuse. Nevertheless, she does not accept satanic abuse, and warns that it is easy to be drawn into the world of these patients, and to feel privileged to have achieved sufficient trust to be the first person to whom the victim has revealed his or her story. Reinforcement and suggestion must occur in these circumstances. Dr Mezey also sees no role for hypnosis even if patients request such assistance to retrieve forgotten memories. Such patients are actively searching for meaning and explanations for their symptoms, and are in an extremely suggestible state.

  It is not hard to anticipate the reaction from some quarters to the La Fontaine report. It will be argued that society has often been reluctant to acknowledge that children are the victims of physical or sexual abuse. True enough, but the historical record also shows that societies have also acknowledged abuse that has never happened. This can have consequences as serious as those of neglect. It is salutary to recall that the epidemic of witch-burning occurred not in a twilight medieval world of superstition, but in the post-Renaissance world of Europe and the North American colonies. Simply because society has been slow to recognise sexual abuse is not justification for allowing emotion to cloud judgment.

  Valerie Sinason's book actually contains much of sense. Dr Gwen Adshead, a  fellow contributor and forensic psychiatrist, points out that as children can be pressured into unwanted sexual intercourse, it is not far-fetched to consider that they may be pressured by professionals and care-givers into false allegations. In adults, the existence of severe psychiatric distress does not ipso facto mean that the trauma reported to be its cause must have happened.

 How have intelligent people come to believe in a conspiracy of leading figures, satanists from cradle to grave, responsible for slaughtering large numbers of victims, yet leaving no trace? One reason is that it is not the role of the therapist to question a patient's beliefs, but instead to show genuine empathy and warmth. These stories may describe an emotional truth, even if not necessarily a factual one. However, some therapists seem to have ignored Dr Adshead's warning that nothing in the professional training of a psychiatrist or psychotherapist gives them any expertise, or any role, in determining the truth.

  Child sexual abuse remains under, and not over, diagnosed. The exponents of satanic abuse have done little to help those they wished to assist children who are the victims of abuse that can be sexual, violent, sordid, terrifying,  even organised, but not satanic.

 The author is a psychiatrist at the Maudsley Hospital.