[Skip to Navigation]
November 26, 1997

The Dilemma of Ritual Abuse: Cautions and Guides for Therapists

Author Affiliations

The Psychiatric Hospital at Vanderbilt Nashville, Tenn

JAMA. 1997;278(20):1709-1710. doi:10.1001/jama.1997.03550200085044

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


Interest in the phenomenon of ritual abuse began in 1980 with the publication of Michelle Remembers, by Michelle Smith and Lawrence Pazder. Dr Pazder, a psychiatrist in Victoria, British Columbia, was treating Smith for multiple personality disorder. One of her child alters described how Smith had been sexually and physically abused during bizarre religious ceremonies and forced to participate in killing babies. Smith and Pazder reported her memories in popular magazines (People and Maclean's), in hardcover (1980), paperback (1981), and in presentations at professional meetings. Before long, hundreds of therapists and thousands of patients recounted recovered memories of "satanic ritual abuse" and "sadistic ritual abuse." Many of these patients had multiple personality disorder, which is now called dissociative identity disorder.

During the late 1980s and the 1990s, psychotherapists took sides on this highly controversial issue. At one extreme, an experienced psychologist said that ritual abuse should be considered and ruled