We Need to Talk about Leading Questions
By Fritha Robinson
I am not old enough to have memories of the recovered memory scandal, but I grew up reading about it in magazines like The Skeptical Inquirer. I was raised by parents who were practicing skeptics, who watched documentaries about the scandal, and I was fascinated by it even before I had decided to study counseling myself. As I learned more, one key lesson was that therapists, when counseling, must avoid influencing patients with their questions.
The recovered memory scandal involved therapists, often unknowingly, implanting false memories of sexual abuse in their clients in the 1980s and 1990s. In some situations, this caused parents and daycare workers to be imprisoned for crimes they did not commit, and, even if their convictions were overturned, their reputations were tarnished. Families were split apart as many people who have false memories of abuse still remain convinced of their authenticity. Those who sought therapy were victimized rather than helped, and that bad therapy resulted in the loss of relationships, broken trust with their caregivers, and memories that, while false, were painful and resulted in significant emotional distress. Although the methods of implanting false memories are beyond this article’s scope, I want to highlight one key element: leading questions.
Counselors implanted false memories in part with leading questions that presumed the patient had been abused even if the patient could not remember it. An example might be, “Patients who have your symptoms were sexually abused, often by a parent. How old were you when your father molested you?” If a patient denied abuse, the counselor would persist until the patient formed a narrative of abuse that did not happen.
Patients are vulnerable to therapeutic suggestion and often take on the therapist’s beliefs. Because of this, it is suggested that therapists do their best to minimize leading questions and allow the patient to articulate the reason behind their symptoms to minimize the influence of the therapist on the reasons behind the patient’s distress. So instead of saying that people with a certain symptom were abused, it is recommended that a therapist ask non-leading questions such as, “You mentioned that your depressive symptoms started when you were thirteen. Tell me what your life looked like then.”
When I decided to become a counselor and went to graduate school, I was surprised by how little we studied the recovered memory scandal and how little attention was paid to how we structured our questions besides keeping them open-ended. And, in my work with people who detransition from a trans identity, I have been horrified by how little our profession learned from the recovered memory scandal because the vast majority of the detransitioners I have worked with did not initially seek therapy believing that they were trans. They sought therapy because they were distressed for other reasons, and a counselor suggested that the source of their distress may be because they were trans. As sessions continued with the counselor directing treatment towards the idea of being trans as the solution to their distress, these vulnerable patients started to believe the counselor was right. Just as some counselors in the 1980s were falsely leading their patients to believe that they had been sexually abused, counselors now are falsely implanting a trans identity in their patients. Our field did not learn its lesson from the recovered memory scandal.
In fact, some of the people who fueled the recovered memory scandal and the related Satanic Panic are now pushing children to believe that they are trans. Diane Ehrensaft, who once convinced girls they had been sexually abused, now convinces children they are trans. In one shocking example, a mother who had a daughter who was a tomboy but comfortable with being female took her to see Ehrensaft, who used an example of a Pop Tart being in the wrong package to convince this girl that, because she liked to dress in a masculine manner, she really was a boy.
Regardless of your theoretical framework, the way we structure questions as counselors is integral to doing effective therapeutic work and to helping our patients get better rather than causing them harm. One outcome I hope to see from our current scandal is a focus in counseling programs and CEUs on how to minimize harm from therapeutic suggestion and how to formulate non-leading questions.
Fritha Robinson is a Licensed Professional Counselor who specializes in recovery from trauma and autism
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