Satanic ritual abuse

Satanic ritual abuse

Satanic ritual abuse (SRA, sometimes known as ritual abuse, cult related abuse, ritualized abuse, sadistic ritual abuse, ritual abuse-torture and other variants) refers to reports of physical and sexual abuse of individuals in the context of occult or "satanic" rituals. Allegations of SRA first appeared in the early 1980s starting in the United States and spreading to other parts of the western world, impacting how legal, therapeutic and social work professions dealt with allegations of abuse. The phenomenon subsided in the late 1990s, with the SRA allegations that appeared in the media, courts and in therapy now generally regarded as having been part of a moral panic. The extent of SRA and the definitions used to label it have always been controversial since the panic was primarily based on reports from children and adults using therapeutic and questioning techniques now considered illegitimate. The only credible evidence of SRA was an extremely small number of cases of child abuse involving abusers contriving rituals to frighten and intimidate victims rather than as an authentic form of worhsip. In the latter half of the 1990s interest in SRA declined and skepticism became the default position, with only a minority of believers giving any credence to the existence of SRA.


Historical precedents

The SRA panic repeated many of the features of historical moral panics and conspiracy theories such as the blood libel against Jews by Apion in the 30s AD, Christians in the Roman empire, later allegations of a Jewish conspiracy alleging the killing of Christian babies and desecration of the Eucharist, the witch hunts of the 16th and 17th centuries. A more immediate precedent to the context of the United States in the 1980s was the 1950s McCarthyism. Allegations of horrific acts by outsider groups, literally the worst imaginable and including cannibalism, child murder, torture and incestuous orgies, may have served as a form of Othering for minority groups, as well scapegoating to provide simple explanations to complex problems in times of social disruption, Torture and imprisonment were used by authority figures to coerce confessions from alleged satanists, confessions that were later used to justify their execution. Records of these older allegations were linked by contemporary proponents in an effort to demonstrate the contemporary satanic cults were part of an ancient conspiracy of evil.

Michelle Remembers and the McMartin preschool trial

In 1980 the book, Michelle Remembers, written by Michelle Smith and husband/psychiatrist Lawrence Pazder, was published. The book, now discredited, was written as an autobiography and was the first known claim linking the abuse of children with satanic rituals and provided a model for allegations of SRA that followed. Michelle Remembers, along with others portrayed as survivor stories, are suspected to have influenced later allegations of SRA and some have argued the book was a causal factor in the later epidemic of SRA allegations. In the early 1980s, during the implementation of mandatory reporting laws there was an exponential increase in child protection investigations in America, Britain and other developed countries and an increased public awareness of child abuse. The investigation of incest allegations in California was also changed, with cases led by social workers using leading and coercive interviewing techniques avoided by police investigators, and alterations to the prosecution of these cases that resulted in a greater number of confessions in exchange for plea bargains from fathers. Shortly thereafter some children in child protection cases began making allegations of horrific physical and sexual abuse by parents and caregivers within organised rituals, disclosing sexual abuse in satanic rituals and the use of satanic iconography, garnering the label "satanic ritual abuse" in the media and among professionals. Childhood memories of similar abuse began to appear in the psychotherapy sessions of adults.

In 1983 charges were laid in the McMartin preschool trial, a major case in California, which received attention throughout the United States, and contained allegations of satanic ritual abuse. The case caused tremendous polarization in how to interpret the evidence that was available and shortly after more than a hundred preschools across the country had similar sensationalist allegations eagerly and uncritically reported by the press. Throughout the trial the media coverage against the defendants (Peggy McMartin and Ray Buckey) was unrelentingly negative, focusing only on statements by the prosecution and continuing throughout the trial. Smith and other alleged survivors met with parents involved in the trial and it is believed that they influenced testimony against the accused.

Social worker Kee MacFarlane, of Children's Institute International developed a new way to interrogate children with anatomically correct dolls and tested their use in assisting disclosures of abuse with the McMartin children. With the dolls and leading questions she diagnosed sexual abuse in virtually all McMartin children, and coerced disclosures using lengthy interviews which rewarded discussions of abuse and punished denials; testimony during the trial was often contradictory and vague on all details except for the assertion that the abuse had occurred. Though the initial charges featured bizarre allegations of satanic abuse, these features were dropped relatively early in the trial and prosecution continued only for non-ritual allegations of child abuse. After three years of testimony, McMartin and Buckey were acquitted on 52 of 65 counts, and the jury was deadlocked on the remaining 13 charges against Buckey with eleven of thirteen jurors choosing not guilty. Buckey was re-charged and two years later released without conviction.

Conspiracy accusations

In 1984 MacFarlane warned a congressional committee of scatological behavior and animals being slaughtered in bizarre rituals which children were forced to watch. Shortly after the United States Congress doubled its budget for child-protection programs. Psychiatrist Roland Summit delivered conferences in the wake of the McMartin trial and depicted the phenomenon as a conspiracy theory, suggesting that people skeptical of SRA were part of the conspiracy. By 1986 Carol Darling, a social worker, argued in a grand jury that the conspiracy reached the government. Brad Darling, her husband, gave conferences about a satanic conspiracy of great antiquity, now permeating American communities. By the late 1980s, the therapists' recognition of SRA could lead to Christian psychotherapy and exorcism, multiple personalities and the development of "survivors" groups. Federal funding was increased for research on child abuse, with large portions of the funding going towards child sexual abuse. Funding was also provided for conferences supporting the idea of SRA, adding a veneer of respectability to the idea as well as offering an opportunity for prosecutors to exchange advice on how to best secure convictions (with tactics including the destruction of notes, refusing to tape interviews with children and destroying or refusing to share evidence with the defence). Sociologist Jeffrey Victor complained that never before had organized and secret criminal activity been allegedly discovered by mental health professionals. In 1987, Geraldo Rivera produced a national television special on the alleged secret cults, claiming "Estimates are that there are over one million Satanists in [the United States and they are] linked in a highly organized, secretive network. Tapings of this and similar talk show episodes were subsequently used by religious fundamentalists, psychotherapists, social workers and police to promote the idea that a conspiracy of satanic cults existed and was actually involved in serious crimes.

Religious roots and secularization

Initial accusations were made in the context of conservative Christianity and religious fundamentalists were enthusiastic in promoting rumors of SRA. Psychotherapists who were actively Christian began advocating for the diagnosis of DID and soon after accounts similar to Michelle Remembers began to appear, with some therapists believing the alters of some patients were the result of demonic possession. Protestantism was instrumental in starting, spreading and maintaining rumours through sermons about the dangers of SRA, lectures by purported experts and prayer sessions, including showings of the 1987 Geraldo Rivera television special. Secular experts began to appear, and secular child protection workers became significantly involved. As the explanations for SRA became secularized and distanced from evangelical Christianity and into the realm of "survivor" groups, the motivations ascribed to purported satanists shifted from combating a religious nemesis to mind control and abuse as an end to itself. Clinicians, psychotherapists and social workers documented clients alleging histories of SRA though the claims of therapists were unsubstantiated beyond the testimonies of their clients.

International spread

In 1987 a list of 'indicators' was published, featuring a broad array of vague symptoms that were ultimately common, non-specific and subjective, capable of diagnosing SRA in most young children. By the late 1980s allegations began to appear throughout the world (including Canada, Australia, the United Kingdom, New Zealand, the Netherlands and Scandinavia), in part enabled by English as a common international language and in at least the United Kingdom assisted by Gould's list of indicators. In 1985 charges were laid in a Hamilton, Ontario case, in 1992 in Martensville, Saskatchewan. In the latter case, charges were overturned in 1995 on the grounds of improper interviewing of the children. San Francisco police detective Sandi Gallant gave an interview with a newspaper in the United Kingdom. At the same time, several other therapists toured the country giving talks on SRA, and shortly thereafter SRA cases occurred in Orkney, Rochdale, London and Nottingham. Writings on the phenomenon appeared in the United Kingdom along with incidents featuring broadly similar accusations such as the Cleveland child abuse scandal. Along with the list of indicators, American conference speakers, pamphlets, source materials, consultants, vocabulary regarding SRA and allegedly funding were imported, which promoted in the identification and counseling of British SRA allegations. The allegations of SRA in Nottingham resulted in the 'British McMartin', advised in part by the British journalist Tim Tate's sensationalist work on the subject. The Nottingham investigation resulted in criminal charges of severe child abuse that ultimately had nothing to do with satanic rituals, and was criticized for focusing on the irrelevant and non-existent satanic aspects of the allegations at the expense of the severe conventional abuse endured by the children. Ultimately Jean LaFontaine produced a report indicating allegations of SRA in the United Kingdom were sparked by investigations supervised by social workers who had taken SRA seminars in the United States. A wave of SRA accusations appeared in New Zealand in 1991, and in Norway in 1992. The largest symposia on child abuse in history, hosted by Australia in August 1986, invited vocal SRA advocates Kee MacFarlane, Roland Summit, Astrid Hager and David Finkelhor to give addresses.

Skepticism and rejection

Media coverage of SRA began to turn negative by 1987, and the "panic" ended between 1992 and 1995. By 2003 allegations of ritual abuse were met with great skepticism and belief in SRA is no longer considered mainstream in professional circles.

Some feminist critics of the SRA diagnoses maintained that, in the course of purging or cleansing evil, the panic of the 1980s and 90s obscured real child abuse issues, a concern echoed by Gary Clapton. In England the SRA panic diverted resources and attention from proven cases of abuse and resulted in a hierarchy of abuse in which SRA was the most serious form of abuse with physical and sexual abuse being minimized, marginalized and "mere" physical abuse no longer worthy of intervention. In addition, as attention towards SRA turned negative, the focus by social workers on SRA resulted in a large loss of credibility to the profession. Unlike the "multiple victims, multiple perps" which characterizes many allegations of SRA, the parental, intrafamilial sexual abuse, which is much part of this world, had thus "been robbed of larger significance. The National Center for Abuse and Neglect devised the term religious abuse to describe exorcisms, poisonings and drownings of children in non-satanic religious settings in order to avoid confusion with SRA. A small number of believers still feel there is credence to allegations of SRA and continue to research the topic.


The term "satanic ritual abuse" is used to describe different behaviors, actions and allegations that lie between extremes of definitions. In 1988, a nation wide study of sexual abuse in U.S. day care agencies, led by David Finkelhor, put forth a three-fold typology to describe "ritual abuse" — cult-based ritualism in which the abuse had a spiritual or social goal for the perpetrators, pseudo-ritualism in which the goal was sexual gratification and the rituals were used to frighten or intimidate victims, and psychopathological ritualism in which the rituals were due to mental disorders. Subsequent investigators have expanded on these definitions and also pointed to a fourth alleged type of satanic ritual abuse, in which petty crimes with ambiguous meaning (such as graffiti or vandalism) generally committed by teenagers were attributed to the actions of satanic cults.

By the early 1990s, the phrase "satanic ritual abuse" was featured in media coverage of ritualistic abuse but its use decreased among professionals in favour of more nuanced terms such as multi-dimensional child sex rings, ritual/ritualistic abuse, organised abuse or sadistic abuse, some of which acknowledged the complexity of abuse cases with multiple perpetrators and victims without projecting a religious framework onto perpetrators.

Conclusions on the origins of allegations of cult-based abuse can include actual abuse by organized groups, pseudosatanism, distortions and false memories, mental illness resulting in false reporting, deliberate lying or hoaxes and in the cases of child testimonies, allegations may be artifacts of the questioning techniques used, and TV special broadcasts.

Cult-based abuse

Allegations of cult-based abuse is the most extreme scenario of SRA. During the initial period of interest starting in the early 80s the term was used to describe a network of Satan-worshiping, secretive intergenerational cults that were supposedly part of a highly organized conspiracy engaged in criminal behaviors such as forced prostitution, drug distribution and pornography. These cults were also thought to sexually abuse and torture children in order to coerce them into a lifetime of Devil worship. Other allegations included bizarre sexual acts such as necrophilia, forced ingestion of semen, blood and feces, cannibalism, orgy, liturgical parody such as pseudosacramental use of feces and urine; infanticide, sacrificial abortions to eat fetuses and human sacrifice; satanic police officers who covered up evidence of SRA crimes and desecration of Christian graves. No evidence of any of these claims has ever been found; the proof presented by those who alleged the reality of cult-based abuse primarily consisted of the memories of adults recalling childhood abuse, the testimony of young children and extremely controversial confessions. The idea of a murderous satanic conspiracy created a controversy dividing the professional child abuse community at the time, though no evidence has been found to support allegations of a large number of children being killed or abused in satanic rituals. From a law enforcement perspective, an intergenerational conspiracy dedicated to ritual sacrifice whose members remain completely silent, make no mistakes and leave no physical evidence is unlikely; cases of what the media incorrectly perceived as actual cult sacrifices (such as the 1989 case of Adolfo Constanzo) have supported this idea.


Satanic ritual abuse is also used to describe the actions of "pseudo-satanists" who sexually abuse children and use the trappings of satanic rituals and claims of magical powers to coerce and terrify victims but do not believe in the rituals. A survey of more than 12,000 SRA allegations, which found no substantiating evidence for an intergenerational conspiracy, did document several examples of abuse by pseudo-satanists.

Criminal and delusional satanism

A third variation of ritual abuse involves non-religious ritual abuse in which the rituals were delusional or obsessive. There are incidents of extreme sadistic crimes that are committed by individuals, loosely organized families and possibly in some organized cults, some of which may be connected to Satanism, though this is more likely to be related to sex ring trafficking; though SRA may happen in families, extended families and regional groups, it is not believed to occur in large, organized groups.

Acting out

Ambiguous crimes in which actual or erroneously believed symbols of satanism appear have also been claimed as part of the SRA phenomenon, though in most cases the crimes cannot be linked to a specific belief system; minor crimes such as vandalism, trespassing and graffiti were often found to be the actions of teenagers who were acting out. Allegations of alleged victims that were obtained from mental health practitioners also occurred, but lacked verifiable evidence, were anecdotal and involved incidents that were years or decades old.


There was never any consensus on what actually constituted satanic ritual abuse. This lack of a single definition for what constitutes SRA, as well as confusion between the meanings of the term ritual (religious versus psychological) allowed a wide range of allegations and evidence to be claimed as a demonstration of the reality of SRA claims, irrespective of which "definition" the evidence supported. Acrimonious disagreements between groups who supported the reality of SRA allegations and those criticizing them as unsubstantiated resulted in an extremely polarized discussion with little middle ground. The lack of credible evidence for the more extreme interpretations can be seen as evidence of an effective conspiracy rather than an indication that the allegations are unfounded. The atheistic or religious beliefs of the disputants have also resulted in different interpretations of evidence, and as well as accusations of those who reject the claims being "anti-child". Both believers and skeptics have developed networks to disseminate information on their respective positions. One of the central themes of the discussion among English child abuse professionals was the assertion that people should simply "believe the children", and that the testimony of children was sufficient proof, which ignored the fact that in many cases the testimony of children was interpreted by professionals rather than the children explicitly disclosing allegations of abuse. In some cases this was simultaneously presented with the idea that it did not matter if SRA actually existed, that the empirical truth of SRA was irrelevant, that the testimony of children was more important than that of doctors, social workers and the criminal justice system.


The evidence for SRA was primarily in the form of testimonies from children who made allegations of SRA and adults who claim to remember abuse during childhood, that may or may not have been forgotten and recovered during therapy. A lack of independent corroborating evidence for many of these claims makes it difficult to put forth a definitive statement about the nature of ritual abuse. Varying definitions of what constitutes SRA also allows evidence to be claimed both for and against the existence of SRA. Despite allegations appearing in the United States, Holland, Sweden, New Zealand and Australia, no material evidence has been found to corroborate allegations of organized cult-based abuse that practices human sacrifice and cannibalism. One investigation in the United Kingdom found material evidence, confessions and statements from multiple victims were invented to justify child sexual abuse, to ensure compliance and prevent disclosure. In these cases, abuse had also occurred outside of rituals, suggesting the ultimate goal was sexual rather than ritualistic or religious. Three cases considered corroborating in North America —the McMartin preschool trial, a pre-school in Country Walk, Florida and the murders in Matamoros, by Adolfo Constanzo— are all problematic. McMartin was extremely controversial and considered ultimately false by professionals and the public; the convicting testimony in the Country Walk case recanted once the witness realized she was not immune from incarceration, and the Matamoros murders produced the bodies of 12 adults who were ritually sacrificed by a drug gang inspired by the film The Believers, but did not involve children or sexual abuse.

Allegations from adult patients

The majority of adult testimonials occurred as a result of adults undergoing psychotherapy, in most cases therapy designed to elicit memories of SRA. The therapists who advocate the veracity of SRA claims cite the pain expressed and the internal consistency of their patients' stories, as well as the similarity of allegations by different patients in geographically separate areas as evidence for the reality of the stories; despite this, the disclosures of patients have never resulted in the discovery of body parts or missing persons that would corroborate the allegations. Randy Noblitt has argued that patient reports of an international satanic conspiracy is evidence of SRA and that this evidence needs to be examined further, though Noblitt has been criticized for an incoherent analysis of SRA allegations, ignoring the larger context of the SRA debate as well as the skeptical literature that exists and violating the principle of parsimony by special pleading when he explains contradictory evidence from his own patients.

Allegations from patients

Many allegations of SRA come from adult patients engaged in therapy who disclose SRA that occurred during childhood. Some psychologists have described substantiated cases of day care sexual abuse which involved ritualistic abuse though some of this research has been criticized for an overly liberal definition of what constitutes a "substantiated" case of ritual abuse. A sample of 29 patients in a medical clinic reporting SRA found no corroboration of the claims in medical records or in discussion with family members.


A survey in the United States found that of 2709 practicing clinical psychologists, 1908 had no patients reporting SRA, 785 found one or two cases, and sixteen had treated more than one hundred patients reporting SRA, suggesting that a minority of therapists may be "highly predisposed" to see a disturbed client as suffering from SRA. Studies in Australia and Britain in the 90's between a third and a quarter of psychotherapists, social workers and counselors have encountered at least one client who discloses allegations of ritualistic abuse. According to Bibby, therapist advocates tend to be very concerned over the damage caused to patients, and usually work to increase awareness of sexual abuse but believe that the reality of the trauma for patients is for them more important than actual proof of the allegations. A 1996 survey of clinician members of the American Psychological Association found a minority of respondents who had encountered allegations of ritual abuse, most of whom believed their clients. In the more than 12,000 cases investigated, the researchers found none in which the histories were concluded as factual.

Allegations involving children

The techniques used by investigators to gather evidence from witnesses, particularly young children, have been criticized for being coercive, leading and suggestive, pressuring young children to provide testimony and refusing to accept denials while offering inducements that encouraged "disclosures". These factors were alleged to have led to the construction of the bizarre disclosures of SRA by the children. A British study found 62 cases of alleged ritual abuse reported to researchers by police, social and welfare agencies from the period of 1988 to 1991 as part of a survey on organized child sexual abuse, noting that all cases of organized abuse represented a "very small proportion" of cases. The investigation did not distinguish between "intergenerational cults" and pseudo-satanic abuse, noting that the survey respondents reported only a minority of these cases that tended to be high-profile. Another British survey in 1994 found an average of 21 out of 242 abuse cases investigated per year in England and Wales involved ritual or satanic abuse. In the ritual abuse cases the rituals were found to be secondary to the sexual abuse. In cases involving satanic abuse, the satanic allegations by younger children were influenced by adults, and the concerns over the satanic aspects were found to be compelling due to cultural attraction of the concept, but distracting from the actual harm caused to the abuse victims. In two studies of day care abuse, those with allegations of ritual elements were reported as having more perpetrators, victims and severity of abuse and alleged victims of SRA demonstrated high levels of traumatization and long-term behavioral effects.


As a moral panic

SRA has been described as a moral panic and compared to the blood libel and witch-hunts of historical Europe, and McCarthyism in the United States during the 20th century. The initial investigations of SRA were performed by anthropologists and sociologists, who failed to find evidence of SRA actually occurring; instead they concluded that SRA was a result of rumors and folk legends that were spread by "media hype, Christian fundamentalism, mental health and law enforcement professionals and child abuse advocates. Sociologists and journalists noted the vigorous nature with which some evangelical activists and groups were using claims of SRA to further their religious and political goals. Other commentators suggested that the entire phenomenon may be evidence of a "moral panic" over Satanism and child abuse. Skeptical explanations for allegations of SRA have included an attempt by "radical feminists" to undermine the nuclear family, a backlash against working women, homophobic attacks on gay childcare workers, a universal need to believe in evil, fear of alternative spiritualities, "end of the millennium" anxieties, or a transient form of temporal lobe epilepsy.

Victor points out that in the United States the groups most likely to believe rumours of SRA are rural, poorly educated religiously conservative Protestant blue-collar families with an unquestioning belief in American values who felt significant anxieties over job loss, economic decline and family disintegration. He considers rumours of SRA a symptom of a moral crisis and form of scapegoating for economic and social ills.

Origins of the rumors

Information about SRA claims spread through conferences presented to religious groups, churches and professionals such as police forces and therapists as well as parents. These conferences and presentations served to organize agencies and foster communication between groups, maintaining and spreading disproven or exaggerated stories as fact. Members of local police forces organized into loose networks focused on cult crimes, some of whom billed themselves as "experts" and were paid to speak at conferences throughout the United States. Religious revivalists also took advantage of the rumours and preached about the dangers of Satanism to youth and presenting at paid engagements as secular experts. At the height of the panic, the highly emotional accusations and circumstances of SRA allegations made it difficult to investigate the claims, with the accused being assumed as guilty and skeptics becoming co-accused during trials, and trials moving forward based solely on the testimony of very young children without corroborating evidence. No forensic or corroborating evidence has ever been found for religiously-based cannibalistic or murderous allegations of SRA, despite extensive investigations. The concern and reaction expressed by various groups regarding the seriousness or threat of SRA has been considered out of proportion to the actual threat by satanically-motivated crimes, and the rare crime that exists that may be labeled "satanic" does not justify the existence of a conspiracy or network of religiously-motivated child abusers.


Jeffrey Victor reviewed 67 rumours about SRA in the United States and Canada reported in newspapers or television, and found no evidence supporting the existence of murderous satanic cults. Lafontaine states that cases of alleged SRA investigated in the United Kingdom were reviewed in detail and the majority were unsubstantiated; three were found to involve sexual abuse of children in the context of rituals, but none involved the Witches' Sabbath or devil-worship that are characteristic of allegations of SRA. Lafontaine also states that no material evidence has been forthcoming in allegations of SRA, no bones, bodies or blood, in either the United States or Britain.

Kenneth Lanning, an expert in the investigation of child sexual abuse, has stated that pseudo-satanism may exist but there is no proof for vast conspiracies and human sacrifices.

There are many possible alternative answers to the question of why victims are alleging things that don't seem to be true....I believe that there is a middle ground — a continuum of possible activity. Some of what the victims allege may be true and accurate, some may be misperceived or distorted, some may be screened or symbolic, and some may be "contaminated" or false. The problem and challenge, especially for law enforcement, is to determine which is which. This can only be done through active investigation. I believe that the majority of victims alleging "ritual" abuse are in fact victims of some form of abuse or trauma.

Lanning produced a monograph in 1994 on SRA aimed at child protection authorities, which contained his opinion that despite hundreds of investigations no corroboration of SRA had been found. Following this report, several convictions based on SRA allegations were overturned and the defendants released.

Reported cases of SRA involve bizarre activities, some of which are impossible (like people flying), that makes the credibility of victims of child sexual abuse questionable. In cases where SRA is alleged to occur, Lanning describes common dynamics of the use of fear to control multiple young victims, the presence of multiple perpetrators and strange or ritualized behaviors, though allegations of crimes such as human sacrifice and cannibalism do not seem to be true. Lanning also suggests several reasons why adult victims may make allegations of SRA, including "pathological distortion, traumatic memory, normal childhood fears and fantasies, misperception, and confusion".

Court cases

Allegations of SRA have appeared throughout the world. The failure of certain high-profile legal cases generated worldwide media attention, and came to play a central feature in the growing controversies over child abuse, memory and the law.

In one analysis of 36 court cases involving sexual abuse of children within rituals, only one quarter resulted in convictions and the convictions had little to do with ritual sex abuse. In a 1994 survey of more than 11,000 psychiatric and police workers throughout the US, conducted for the National Center on Child Abuse and Neglect, researchers investigated approximately 12,000 accusations of group cult sexual abuse based on satanic ritual. The survey found no substantiated reports of well-organized satanic rings of people who sexually abuse children, but did find incidents in which the ritualistic aspects were secondary to the abuse and were used to intimidate victims. Victor reviewed 21 court cases alleging SRA between 1983 and 1987 in which no prosecutions were obtained for ritual abuse.

During the early 1980s, some courts attempted ad hoc accommodations to address the anxieties of child witnesses in relation to testifying before defendants. Screens or CCTV technology are a common feature of child sexual assault trials today; children in the early 1980s were typically forced into direct visual contact with the accused abuser while in court. SRA allegations in the courts catalyzed a broad agenda of research into the nature of children's testimony and the reliability of their oral evidence in court. Ultimately in SRA cases, the coercive techniques used by believing district attorneys, therapists and police officers were critical in establishing, and often resolving, SRA cases. In courts, when juries were able to see recordings or transcripts of interviews with children, the alleged abusers were acquitted. The reaction by successful prosecutors, spread throughout conventions and conferences on SRA, was to destroy, or fail to take notes of the interviews in the first place. One group of researchers concluded that children usually lack the sufficient amount of "explicit knowledge" of satanic ritual abuse to fabricate all of the details of an SRA claim on their own. However, the same researchers also concluded that children usually have the sufficient amount of general knowledge of "violence and the occult" to "serve as a starting point from which ritual claims could develop."

Dissociative identity disorder

SRA has been linked to dissociative identity disorder (DID, formerly referred to as multiple personality disorder or MPD), with many DID patients also alleging cult abuse. Many DID patients report memories that they allege are forms of ritual abuse though most are undocumented. The first person to publish a survivor story about SRA was Michelle Smith, co-author of Michelle Remembers; Smith was diagnosed by her therapist and later husband Lawrence Pazder with DID.

A survey investigating 12,000 cases of alleged SRA found that most were diagnosed with DID as well as post-traumatic stress disorder. The level of dissociation in a sample of women alleging SRA was found to be higher than a comparable sample of non-SRA peers, approaching the levels shown by patients diagnosed with DID. A sample of patients diagnosed with DID and reporting childhood SRA also present other symptoms including "dissociative states with satanic overtones, severe post-traumatic stress disorder, survivor guilt, bizarre self abuse, unusual fears, sexualization of sadistic impulses, indoctrinated beliefs, and substance abuse". Commenting on the study, Philip Coons stated that patients were held together in a ward dedicated to dissociative disorders with ample opportunity to socialize, that the memories were recovered through the use of hypnosis (which he considers questionable). No cases were referred to law enforcement for verification, nor was verification attempted through family members, that existing injuries could have been self-inflicted, that the experiences reported were "strikingly similar" and that "many of the SRA reports developed while patients were hospitalized". The reliability of memories of DID clients who alleged SRA in treatment has been questioned and a point of contention in the popular media and with clinicians; many of the allegations made are fundamentally impossible and alleged surivors lack the physical scars that would result were their allegations true.

Many women claiming to be SRA survivors have been diagnosed as sufferers of DID, and it is unclear if their claims of childhood abuse are accurate or a manifestation of their diagnosis. A sampling of 29 patients who presented with SRA, 22 were diagnosed with dissociative disorders including DID. The authors noted that 58% of the SRA claims appeared in the years following the Geraldo Rivera special on SRA and a further 34% following a workshop on SRA presented in the area; in only two patients were the memories elicited without the use of "questionable therapeutic practices for memory retrieval." Claims of SRA by DID patients have been called "...often nothing more than fantastic pseudomemories implanted or reinforced in psychotherapy" and SRA as a cultural script of the perception of DID. Some believe that memories of SRA are solely iatrogenically implanted memories from suggestive therapeutic techniques, though this has been criticized by Daniel Brown, Alan Scheflin and Corydon Hammond for what they argue as over-reaching the scientific data that supports an iatrogenic theory. Others have criticized Hammond specifically for using therapeutic techniques to gather information from clients that rely solely on information fed by the therapist in a manner that highly suggests iatrogenesis. Skeptics claimed that the increase in DID diagnosis on the 1980s and 1990s and its association with memories of SRA is evidence of malpractice by treating professionals.

Noblitt states that he has consulted with patients showing signs of both DID and ritual abuse and defines "ritual abuse as abuse that occurs in a ceremonial or circumscribed manner for the purpose of creating or manipulating already created alter mental states.

Much of the body of literature on the treatment of ritually abused patients focuses on dissociative disorders.

Some "survivors" have re-evaluated their own allegations of SRA, believing the memories of satanic ritual abuse were the result attempt to deal with actual abuse using dissociative processes that produced false memories.

False memories

SRA allegations have been blamed on false memories caused by the over-use of hypnosis by therapists who underestimate suggestibility of their clients. Advocates of false memory syndrome (FMS), a controversial term promoted by the False Memory Syndrome Foundation, claim that false memories are created iatrogenically through suggestion or coercion. Noblitt and Perskin argue that the FMSF circulates data that comes from biased and unscientific sources and from the same data derives unfounded conclusions. The FMSF has used the idea of ritual abuse as a strategy to illustrate their position that most allegations of sexual abuse are preposterous. According to Kathleen Faller this has contributed to the sensationalization of the ritual abuse cases in the media.

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