Steven Mirin, M.D.., Executive Director
American Psychiatric Association
1400 K Street, N.W.
Washington, DC, 20005

Dear Dr. Mirin:

I am writing to express my deep disappointment at your organization's 
complete failure to discipline your own profession or even to 
establish clear guidelines by which professional misconduct can be 
judged.  Your inaction in the face of an epidemic of malpractice  
silently condones the worst excesses of irresponsible and incompetent 
therapists, leaves clients and families vulnerable to irreparable 
harm, and justifiably erodes the credibility of your organization, 
your profession, and all of its members.

I am referring, of course, to your organization's failure to issue 
clear, principled, unambiguous, scientifically-based guidelines 
banning the use of so called "memory recovery therapy," a set of 
techniques which was rushed into use nationwide in the 80s without
any testing for safety and effectiveness and which has been utterly
discredited by the impossible "memories" it "recovers" including
alien abduction, ritual satanic abuse, and past lives.

Defining the standard of what constitutes professional conduct is 
your organization's responsibility by the principle of professional
self-regulation.  Your silence on the topic of so-called "memory
recovery therapy" demonstrates a glaring lack of concern for the 
welfare of clients and the protection of the public and a clear
abrogation of your duty.

The contrast of your organization's conduct with that of the Royal
College of Psychiatrists in the U.K. is painful.  The Royal College
formed a Working Group on Reported Recovered Memories of Child 
Sexual Abuse and adopted the group's "Recommendations for Good 
Practice" as official practice guidelines.  These guidelines state
in part that "Psychiatrists are advised to avoid engaging in any  
'memory recovery techniques' which are based upon the expectation  
of past sexual abuse of which the patient has no memory. Such  
'memory recovery techniques' may include drug-mediated interviews,  
hypnosis, regression therapies, guided imagery, 'body memories',  
literal dream interpretation and journaling."  Your organization's
failure to issue equivalent guidelines silently condones the 
continued use of these harmful, discredited techniques in the U.S.
by your own membership.

This failure has not gone unnoticed.  In their report "Recovered 
Memories of Childhood Sexual Abuse: Implications for Clinical
Practice" in the British Journal of Psychiatry, Sydney Brandon 
et al note that "the polarisation of views and fierce controversy
within the American psychiatric community was in danger of bringing
psychotherapy into disrepute."  Evaluating the statements issued 
by the American Psychiatric Association, the American Psychological
Association, and the American Medical Association, Brandon further 
notes that "In their efforts to remain impartial they have failed
to resolve the impasse between research and clinical observation."

Much damage has already been done.  History will judge your
profession harshly for failing to base its practices on the results
of scientific research and for failing to insulate your practitioners 
(and even your continuing education programs!) from therapeutic fads 
arising from pop psychology bestsellers and the beliefs of untrained,
unlicensed "authorities" like Ellen Bass and John Bradshaw.

However, it is not too late for your organization to reform your
profession and reduce the risk of future malpractice and injustice.
In order to protect clients and their families from the use of 
demonstrably harmful "therapies," please take the following steps at

1. Form an official working group to revise your organization's 
   statement on "recovered memories" of childhood abuse by 
   evaluating the Royal College's "Recommendations for Good Practice" 
   and adopting them as binding practice guidelines for your own 
   membership.  These guidelines can be found online at:

2. Revise your code of ethics to make it mandatory for your 
   organization's members to inform clients about the known risks, 
   benefits, and alternatives to any proposed therapy and to gain 
   their written informed consent prior to beginning therapy.

3. Following the example of the Canadian Psychological Association,
   publicly call for a government review of all convictions which   
   were based on so-called "repressed memory" testimony.

If you fail to take these minimal steps to ensure patient safety
and professional responsibility, the American public will have to
wonder why you fail to act where the Royal College has taken a clear 
stand.  Will it be because you are less well informed, less  
responsible, or less concerned about patient welfare and justice  
than your British and Canadian counterparts?