Of course, there will be cases in which individuals accept such presuppositions in a nonmanipulative environment, which makes the differential diagnosis task more difficult. Thus, converts make "choices" and "deliberate," but without a full awareness of how their deliberations and choices are manipulated at certain key points.

When manipulation and neediness are high, deliberation will be emotionalized and dissociated, and the psychodynamic and thought reform models will both apply. Because little has been written about cases that would fall within this cell, more investigation is needed.

Deception-Dependency-Dread

 The manipulativeness of cults is similar to the debility-dependency-dread (DDD) syndrome explanation of how the Chinese communists were able to gain a high degree of control over American POWs during the Korean conflict (Farber and colleagues). Contemporary cults, which operate in an open society and do not have the power of the state at their disposal, cannot forcibly restrain prospects and run them through a debilitating regimen. Instead, they must fool them. They must persuade prospects that the group is beneficial in some way that appeals to the targeted individuals. As a result of this deception and the systematic use of highly manipulative techniques of influence (see Cialdini for an overview of social-psychological manipulation), recruits come to commit themselves to the group's prescribed ways of thinking, feeling and acting. By gradually isolating members from outside influences, establishing unrealistically high, guilt-inducing expectations, punishing any expressions of "negativity," and denigrating independent critical thinking, the group causes members to become extremely dependent on its compliance-oriented expressions of love and support. Once a state of dependency is firmly established, the group's control over members' thoughts, feelings and behavior is strengthened by the members' growing dread of losing the group's psychological support (physical threat also occurs in some groups), however much that support may aim at ensuring their compliance with leadership's often debilitating demands. Thus, the new DDD syndrome is one of deception, dependency and dread.

What Happens to Cult Members?

 The limited research and clinical data concerning cult members seems at first to be perplexing and contradictory. On the one hand, clinicians tell us that cult environments attempt to surreptitiously reshape their members' personalities (Clark; Singer; West and Martin), a process that on its face should be fraught with tension. On the other hand, some studies indicate that cult members score in the normal range on personality tests, despite some evidence of attempts to "look good" (Ross; Ungerleider and Wellisch). Other research (Galanter and others; Galanter) indicates that joining a cult may reduce perceived distress. Research on cult departure (Skonovd; Wright), however, suggests that members feel extreme pressure to remain in the cult, and research on postcult effects (Galanter; Martin and others) indicates that those who leave experience considerable distress after their return to the mainstream world. Langone (1993) comments:
 


If they [ex-cult members] were unhappy before they joined, became happier after they joined, were pressured to remain, left anyway, and were more distressed than ever after leaving, what could have impelled them to leave and to remain apart from the group? The inescapable conclusion seems to be that the cult experience is not what it appears to be. Clinical observers, beginning with Clark (1979) and Singer (1979), appear to be correct in their contention that dissociative defenses help cultists adapt to the contradictory and intense demands of the cult environment.

The dissociation-mediated tension between benign appearance and abusive reality tends to destabilize members' commitment to the group. The majority (90 percent or more) of cult members eventually leave their groups (Barker; Galanter). However, individuals' psychological distress when they leave their groups is substantial and typically misunderstood by themselves, their families and helping professionals. Therefore, clinicians should not dismiss families seeking help for cult-involved loved ones because the odds say that they will probably eventually leave. There is no way to predict in the individual case whether a particular person will be among the 90 percent who leave, how long "eventually" will take, or how distressed the person will be when he or she leaves the group.

Psychotherapist's Role

 Former cult members, families of currently or formerly involved cult members, and occasionally current cult members may contact psychotherapists for assistance.

Helping former cult members. Former cult members who seek treatment tend to describe their cult experience as abusive or traumatic (Langone and Chambers). Frequently, however, their understanding of their experience is limited, if not faulty. As with many other victims of abuse, they continue to blame themselves inappropriately for distress resulting from the psychological assault of the cult. It is usually advisable, therefore, that therapists take an active stance with ex-cult members and not rely too much on reflection and paraphrase; otherwise, patients may project their failure onto the therapist's "blank screen" and leave treatment prematurely.

Clinicians should make a cult-sensitive assessment. They should not rush to a diagnosis, for much of the emotional turmoil of former cult members is a direct result of psychological assault, not long-standing personality patterns or conflicts. Clinicians should evaluate the positive as well as the negative influences of the cult environment and patients' psychosocial histories in order to identify those factors that may have rendered them susceptible to cultic manipulations and those precult psychological problems that may reemerge after the cult experience.
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