Book Review: Switching Time

For interested readers, this is a preview of a book review that will appear in the FMSF Newsletter, January 2008. A PDF version is also available.

Preface: Is the story true? Does it matter? How short a memory does our culture have? Stories of satanic ritual abuse cults were discredited in the mid-1990s. Yet this year, 2007, we have seen the revival of an Ohio lawsuit claiming abuse by such a cult. We have seen mainstream media such as National Public Radio and Newsweek give extensive and uncritical coverage to a book about such abuse. Does it matter? We think it does because people make sense of their own lives by what they see and hear around them. If fantasy is presented as fact in media that people consider trustworthy, some people may come to reinterpret their own lives and problems in terms of that fantasy. Thousands of individuals and families were tragically and unnecessarily destroyed by the unfounded beliefs in the accuracy of recovered memories as well as beliefs in the reality of multiple personalities and satanic ritual abuse cults during the late 1980s and early 1990s. Can it happen again?

According to Chicago psychiatrist Richard Baer, in January 1989, a 29-year-old woman [1] presented to him with chronic pain that had begun with the birth of her second child three and a half years earlier. She had had a Caesarian section that was complicated by an infection. Unfortunately, a part of her lung had to be removed as a consequence. The woman, whose name in the book is "Karen," was depressed. She reported that her marriage was falling apart and that she had gained 100 pounds. Who would have suspected that her real problem was multiple personality disorder caused by horrific ritual abuse as a child? Baer told his patient:

"It's clear to me you're troubled by depression, ... and that this depression was triggered by the pain following Sara's birth, but is chiefly caused by the hurtful relationships you've suffered, and continue to suffer, throughout your life." (Page 67)

Switching Time has three sections and an index. Part one describes the first three years of therapy when Dr. Baer, who was then thirty-seven- years-old and in his 7th year of practice, treated Karen for depression while harboring suspicions that she had multiple personality disorder. For example, in August 1990, Dr. Baer writes:

"She's given me enough history now to know she has dissociative identity disorder (DID). I wonder if she has actual multiple personality disorder (MPD), which I feel is a better name for the disorder where a person has multiple autonomous discreet personalities... If Karen has MPD, our first problem is that the part of her that comes to see me doesn't realize it (Page 29)

In January 1991, Baer interprets one of Karen's dreams. He writes:

"This dream is more evidence that Karen has multiple personality disorder, with separate adult and children personalities, and that our path together leads toward trying to make them disappear." (Page 34)

Dr. Baer has shown that he had clear expectations that Karen was harboring multiple personalities. It is almost inevitable that these expectations set in motion a host of attitudes, comments, responses, and even non-verbal cues in the course of the therapy that led to the expectations being met. The second section of the book begins in 1993 when Dr. Baer finally meets an alter. He describes his conversations with the seventeen alters that he excavated with the use of hypnosis. The last section of the book describes how Dr. Baer and Karen grieved the departure of the alters as they were integrated. Finally, after 18 years of therapy, Karen was declared well.

Hundreds of pages of the book are discussions with and about alter children. The many child alters describe the same abuse scenes but from their own perspectives and with different details. Reading about the horrific abuse Karen endured seems, at times, voyeuristic. Most of the alters are children. They tell Dr. Baer that they came into being when Karen was being abused. When the alters were no longer needed, they stopped growing older and remained that age.

"It's clear that many of the parts are anxious to communicate with me, and find it easier to do so by writing. What strikes me is how distinct each part is. Each has its own voice and its own concerns. Except for Katherine and Holdon, who aged as Karen aged, the other parts ceased to age and grow. At a different moment for each part, time stopped, and the events occurring at that instant, like for Claire when she was seven, are still occurring. It is as if some of the parts are suspended forever in a freeze-frame of torment. It sounds like a definition of hell." (Page 147)

When Karen first presented to Dr. Baer, he writes of feeling annoyed that she seemed "determined to wallow and rut around in...self- defeating emotions." (Page 11) He decides to focus on treating the depression because it will be a short-term task rather than focus on her more complicated personality problems. After one session during which he tripled the dose of medication he had prescribed for her, Karen stops coming to see him. Baer reflects on what he may have done that contributed to that.

After several months, Karen returns and Baer decides that he should try to empathize with Karen's hopelessness and helplessness. (Page 13) Karen begins to open up and tells him her husband is abusive. Towards the end of 1989, Karen sends him a note that he interprets as suicidal and he has her admitted to a psychiatric hospital [not identified]. Karen stays in the hospital for a month and in a letter to Baer, she first mentions abuse by her father. "My dad used to make us [Karen and her girlfriends] take our clothes off and lie down on the bed. He tied our hands to the headboard with electrical cords, and beat us with his belt, the buckle side. The more we cried, the more he beat us." She claimed that she was beaten 3 to 5 times a week from age 5 to about 16. Karen says that once her father threw a meat fork at her and that it stuck in her thigh.

When Karen resumes regular therapy sessions, Baer believes that she is still suicidal so he stays in close contact with her. In addition to the therapy sessions, she phones him two or three times a week, sometimes as late as 1:00 a.m. Apparently the frequent contact with phone calls continued during the years of therapy. In 1995, Baer wrote:

"I spend hours on the phone with Karen each week listening to the particular day's unpleasantness, and it is stressful for me, too. I try to take her calls after my children have gone to bed, but then I see my wife's back stiffen when she asks whom I'm talking to and my answer is always the same." (Page 173)

Baer and his patient have a close relationship-they were together for 18 years. Although Baer did the actual writing of the book, Karen helped proof it for content and she wrote a few pages. Karen tells Baer "You were my real father, Dr. Baer; I never really had one until you." Baer replies, "I feel like I helped raise you. I was certainly a father to Miles, Claire, Sidney, and the others [the alters]." (Page 341)

After a year and a half of therapy, Karen reveals that she has had periods of time for which she can't account. Baer notes that Karen had given him enough history for him to know that she had dissociative identity disorder. Karen then reveals that she started getting an urge to hurt herself about a year earlier. (That would have been approximately six months after starting therapy with Baer.) Karen tells him that one way she hurts herself is by sticking "a wire hanger up inside her vagina." (Page 30)

After Karen describes one of her dreams, Baer sees "more evidence that Karen has multiple personality disorder." In 1993, he writes:

"With all the history of lost time and her abusive childhood, I'm working under the hypothesis that Karen suffers from multiple personality disorder (although the part that comes to see me doesn't know it)." (Page 84)

Baer wants: "to find a way to communicate with the other parts of her that have remained hidden" (page 102) He decides to do this with the use of hypnosis. He has been collecting material on multiple personality disorder and has a whole bookshelf devoted to the subject. Specifically mentioned is Frank Putnam's 1989 book "Diagnosis and Treatment of Multiple Personality Disorder which, Baer says, explains that multiple personality disorder is a consequence of abuse accompanied by extreme sadism, assaults with objects, bondage, burning and cutting. (Page 92)

"Because I know how hypnotizable multiple personality patients are reputed to be, I don't doubt that I can hypnotize Karen." (Page 103)

Baer paves the path for Karen to come up with alter personalities. When he first puts her into a hypnotic trance in order to find her alters he tells her what she will find:

"You may not have noticed it before, but there's another door to your safe place. Through this door we may meet some of the other parts within you." (Page104)

The alters emerge with lewd stories of abuse. Some examples:

"Just then a large gray hearse pulls up, and backs partway into the garage. Karen and Donna watch three men get out: Donna's father, Mr. Pankratz, who is a friend of Karen's father, and two other men who help him when he goes to pick up bodies. The men go around and open the back of the hearse and pull the stretcher out that holds a corpse. Donna's father looks at the other two men, grins and winks, and then unzips the bag. The bag falls open and reveals the body of a withered old man who has, in death, an erect penis. Karen gasps and Donna screams. The three men laugh and Donna's father walks over to them standing between them and the still-open garage door. "C'mon, girls, want to see a really stiff dick, a frozen Popsicle?.... (Page 77)

"Take off your pants, Karen," her father says, "we're going to make you feel good." He smiles at her in an odd and cold way, and he tosses her coat into the corner. Karen pulls down her pajama bottoms quickly and steps out of them. She's naked from the waist down. A few of the men come closer and stare at Karen as she stands by the side of the table (page 78)

"They put us in ice water mixed with blood from a corpse. Then they rinsed us off and put us in the coffin. They said we had to die if we were to be reborn. But they were laughing; they thought it was a big stinking joke. Claire was scared, and she started screaming when they closed the lid. They would open the lid and then close it again, a little longer each time, each time Claire screamed, and each time they laughed. So I came out and I wouldn't scream. They opened the lid and I just stared at them, so they slammed the lid and kept it closed a long time. I closed my eyes and waited to die. I couldn't breathe I wanted to kick and scream; I couldn't stand it. Then I don't remember" (page 163)

In addition to the abuse by her grandfather, her father and his friends, Karen's mother also abused her. The mother "scrubbed her face with a wire brush for putting on makeup" (page 135) and "burned her with a curling iron." (Page 308) Karen's parents beat her because she was born with a tumor on her forehead that had to be surgically removed (page 161).

In 1990, Baer was not sure of the historical accuracy of Karen's accounts:

"As a practical matter for therapy, however, it matters less what actually happened-how much of these memories are real. These are the images in Karen's mind, and they, and the feelings associated with them, are real to her. Memories from childhood can be distorted, combined, substituted, and altered in a number of different ways. Although I have no reason to doubt Karen, and I know that children are sexually abused all the time, it still seems incredible to be sitting with someone who's survived all this. But I don't have to decide exactly what happened; I just need to understand what Karen thinks and feels. That's enough for now." (Page 26)

Are Karen's stories of abuse true? Readers are asked to accept Switching Time as presented. "Karen" is not the patient's real name and there is no way to confirm events with siblings, teachers, neighbors, or others.

Evidence that there could be truth to the stories, Baer explains, is that in 1992, Karen's father was convicted of abusing her niece. Karen did not take the opportunity, however, to testify about her own abuse by him, which is strange. We have to take Baer's word about the conviction, since he provides no way for readers to verify the facts. Baer also presents a taped transcript of a conversation between Karen's mother and father that is crude at best and identifies the father as an unsavory character. Even if the tape is accurate, it is a far way from child abuse. However, Dr. Baer believes that Karen's stories are true, and he could see no reason why someone would invent such horrors. He is also reassured by her manner in telling the stories:

"I'm swayed by the utterly convincing way in which she narrates these events on tape." (Page 85)

To anyone who has read similar books or survivor narratives, there is something suspiciously familiar about many of Karen's stories. They are stereotypical survivor stories. For example, in 1994, an entire issue of the publication Psychohistory (Vol. 21 No. 4), a journal noted for its support of recovered memories and belief in satanic ritual abuse, was devoted to the topic of "coffins". From one story "One of the worst memories I have is of being buried alive, and the sacrifice that preceded it." In the same issue, a psychiatrist from New York, Robert Rockwell, who later had his license suspended after an investigation of his treatment of patients for cult abuse, wrote that one of his patients had been raped, covered with blood and buried in a coffin-like box. She was later removed, tossed in a lake, cleaned up, and taken home.[2] During the early 1990s, such stories could be found in popular articles, books and especially on television talk shows. Victims of Memory (1996) by Mark Pendergrast has many examples of "survivor" stories told by the people he interviewed.

Although in interviews Dr. Baer has said that it was not possible to find confirmation, it isn't clear that he looked very far or very hard. It seems highly unlikely that the parents of Karen's girlfriends would not have noticed the welts and bruises left by being beaten with the buckle end of a belt. A meat fork thrust into a leg could likely leave a scar. Surely Karen's school work and attendance would have suffered from abuse 3 times a week from age 5 to fifteen, often taken out of bed in the middle of the night, brought to a funeral home, sexually abused, and put in a coffin. Wouldn't neighbors have noticed a child being taken from her home in the middle of the night on a regular basis? Wouldn't people near the funeral home be suspicious of so much middle of the night activity? Wouldn't teachers have noticed a child whose face had been scrubbed with a wire brush and asked some questions? There seem many obvious holes in the abuse stories, unless one resorts to conspiracy theories.

A significant stumbling point in belief is the fact that Karen left her own children with her parents. Why would she leave her children with parents whom she has described as seriously abusive? Karen does make the point of explaining that she never left the children alone with her father but only when the mother was present. However, we had been told that the mother also abused her by scrubbing her face with a wire brush, burning her neck, and beating her. Certainly the presence of the mother did not prevent Karen from being ritually abused by her father and his friends in their small cult. Karen claims she hated her mother and wanted her to die as she was growing up. Even Baer relates that he often wondered, "why years ago she didn't run as far from her parents as she could get. She never has an answer for this - she only shrugs." (Page 48)

The fact that the alters and most stories were revealed under hypnosis is a compelling reason for skepticism about the stories related in Switching Time. The literature on the suggestibility of people who undergo hypnosis is vast. For example, as long ago as 1985 the American Medical Association stated:

"The Council finds that recollections obtained during hypnosis can involve confabulations and pseudomemories and not only fail to be more accurate, but actually appear to be less reliable than nonhypnotic recall."

Indeed, hypnotically enhanced memories are so unreliable that they are not permitted as evidence in court in most states. People who come to believe things while under hypnosis may claim specific and detailed memories, and they may feel certain of their accuracy. Years of research, however, have shown that such confidence is unrelated to historical accuracy.

The most obvious reason for skepticism is that all these terrible things allegedly happened to Karen and she did not remember them. There simply is no scientific evidence that can support such a notion. Although belief in historically accurate recovered repressed memories is frequently found in books and movies, it is just that: fiction. There are hundreds of scientific studies all showing that traumatic events and emotional events are particularly remembered. An article appearing Scientific American Mind [3] in the same month as the release of the book provides an excellent summary of the scientific status of "recovered memories."

Baer recognizes that there is a controversy about the diagnosis of multiple personality. He writes: "Most psychiatrists have never seen a case of MPD, and I think a true multiple personality is quite rare, although many have been "suggested" into being by overzealous therapists who want to say they've treated one." (Page 29) Baer tries to show that Karen's multiple personality was not the result of familiarity with suggestive books or movies. He asks: "Have you ever heard of this disorder before? Did you see the movie Sybil?" Karen replies: "No, I've heard the term, but I always stayed away from those movies; I'm not sure why." (Page 93)

Even though he is aware that MPD can be created and even though he is sure that he did not create it in Karen, it still seems highly probable that Karen and Baer together created the beliefs labeled "memories and alters." First of all, from the start of their therapy together, Baer assumed he had knowledge about Karen that she did not have, that there were "secrets" that Karen had hidden. Baer would likely have been looking for evidence to support his assumption.

"I want to understand more about Karen's unconscious feelings, about the secrets she doesn't yet have the courage to verbalize." (Page 24)

In the early 1990s, Chicago was alive with stories of satanic abuse rituals. It was the home to "Believe the Children," a group that held conferences and rallies about the horrors of ritual abuse of children. We know Karen had contact with this group because she gave Baer a card with their name and logo. (Page 130) People were supposed to believe any story of abuse that children related. Chicago was the home to Bennett Braun, MD, who held conferences and trained other doctors on how to use hypnosis to find the alters of people with MPD and to elicit their stories of ritual abuse. (Braun was later expelled from the American Psychiatric Association, had his Illinois license revoked for many years, and lost or settled multiple multi-million dollar lawsuits because of these practices, one in excess of $10 million.) Given the fact that Baer had an appointment in the psychiatric hospital where Dr. Braun worked with his MPD patients, it seems likely that he was aware of and absorbed some of the prevalent beliefs- although Braun is nowhere mentioned in the book. It's even possible that he had Karen admitted to that same hospital in 1989. We don't know.

Without details to confirm, readers are dependent entirely on Baer's stories. That can be risky as has been shown in many other books. For example, Sybil, long the prime example of a multiple personality patient, has been shown to be a hoax.[4] Binjamin Wilkomirsky's memoir of recovered memories of a childhood in concentration camps, a book that received many awards, was later exposed as fraudulent.[5] Even Oprah was embarrassed by the falsities in James Frey's Million Little Pieces.[6]

Baer provides some insights about himself. His career path indicates he is ambitious. Back in 1989, he is not satisfied with his suburban psychiatric practice and decides to move his office from the suburbs to the center of Chicago.

"If I don't get out of here, I'm going to be looking at this same traffic in twenty years." (Page 17)

He's obviously looking for more challenging and more interesting activities. He tells us that he interviewed for positions as chairman at departments of psychiatry at three of the teaching hospitals in the city and suburbs. (Page 84) In 1994, Baer began to work for Medicare Program and saw patients just one half day a week (page 101) By 1996, Baer writes he had to give up his half day a week of psychiatric practice. Karen became his only patient and he met with her in his apartment (184) Baer writes that his work with Karen was the most important work of his professional life.

"Treating Karen had been the most important and deeply fascinating experience of my professional life. We'll both be mourning [for the alters]. (Page 330)

With time, Baer became invested in his diagnosis and the stories. It seems highly probable that Baer was open to the excitement that a patient with multiple personality brought him. He portrays himself as a hero in Switching Time. And it seems equally probable that Karen was comforted by the diagnosis of multiple personality because it gave her answers for her problems in life, answers that showed that she was not responsible for her problems. Set in a social and therapeutic background that supported beliefs about multiple personality, recovered memories of child abuse, and satanic rituals, it's easy to understand how such stories could develop. Indeed, perhaps this book's greatest interest is as an example of a therapist's thought processes as he and his patient create multiple personalities.

[1] On page 334, we are told that Karen was 38 in 1998.

[2] Robert B. Rockwell, R.B. (2004). One psychiatrist's view of satanic ritual abuse. The Journal of Psychohistory Vol. 21 No. 4, pp.443-460. He also wrote: "I decided to attend the next annual meeting of the International Society for the Study of Multiple Personality and Dissociation in Chicago. There I met many other therapists from all over the United States... who reported similar tales of their patients suffering ritualized torture..." (p.447).

[3] Lambert, K. and Lilienfeld, S.O. (2007, October/November). Brainstains. Scientific American Mind, 46-53.

[4] Dr. Herbert Spiegel, a Columbia University psychiatrist who worked with Sybil for four years, did not believe that Sybil had multiple personality disorder, but rather her behavior was a consequence of her treatment by Dr. Wilbur. See Borch-Jacobsen, M. (1997, April 24). Sybil-The making of a disease: An interview with Dr. Herbert Spiegel. New York Review of Books, 44(7). The audiotapes of treatment sessions and conversations between Dr Wilbur and author Flora Rheta Schreiber that have been discovered document the "fraudulent construction of a multiple personality." See Rieber, R.W. (1999). Hypnosis, false memory and multiple personality: a trinity of affinity. History of Psychiatry. The documentation that the stories of her real childhood do not match the childhood in Sybil. See Miller, M. and Kantrowitz, B. (1999, January 25). Unmasking Sybil. Newsweek, 66-68. (And some other news reports.) Memory research of the past decade that shows that the suggestive therapeutic techniques used by Dr. Wilbur with Sybil can cause the symptoms of MPD. See Piper, A. and Merskey, H. (2004). The persistence of folly: A critical examination of dissociative identity disorder. Part I and 2. Canadian Journal of Psychiatry, 499 and(10). Spanos, N.P. (1996). Multiple Identities and False Memories. American Psychological Assn McHugh, P. (1995). Dissociative identity disorder is a socially constructed artifact. Journal of Practical Psychiatry and Behavioral Health 1. Most psychiatrists are dubious about the diagnosis in general and question the possibility of iatrogenesis in specific. See Pope, H.G. et al. (1999). Attitudes toward DSM-IV dissociative disorders diagnoses among board-certified American psychiatrists. American Journal of Psychiatry 156(2).

[5] In 1995 Binjamin Wilkomirski, a Swiss clarinetist, published a memoir entitled Fragments: Memories of a Wartime Childhood 1939-1941, describing his experiences as a child survivor of the Holocaust. In August 1998 Swiss journalist Daniel Ganzfried first raised questions about the historical accuracy of the book. Later articles in Granta, The New Yorker and documentaries on 60 Minutes and the BBC provided sufficient evidence for the publisher to withdraw the book.

[6] In 2006 James Frey's memoir, Million Little Pieces was shown to be highly fictionalized and Oprah withdrew it from her book club recommendations.