The Importance of Religious/Ritual Abuse as a Traumatic Predictor of Dissociation

Abstract

This study aimed to ascertain the prevalence of different types of Religious/Ritual Abuse (RA) among Iranian young adults and to investigate the relationships between RA, childhood and recent trauma, and different patterns of dissociativity. A total of 100 male and 100 female university students completed and returned a 51-item questionnaire designed to detect the extent of dissociation, childhood and recent trauma history, and RA; 12.5% of participants reported history of RA. Pearson correlation analysis showed that RA strongly correlated with dissociativity. The most notable finding of this study is that RA and being victim of violence within the last 3 years are the most important traumatic predictors of dissociativity. More research on the nature of the relationship between RA and dissociation is suggested.

Keywords

trauma dissociation religious abuse ritual abuse

Introduction

Any form of abuse, including physical harassment, humiliation, and sexual abuse, occurring under the guise of religion is defined as religious abuse (Wright, 2001). Religious abuse has also been referred to as spiritual abuse (VanVonderen, n.d.), ritual abuse, and/or satanic ritual abuse (SRA; Pazder & Smith, 1980). With regard to ritual abuse, Noblitt (2007) proposed that most empirical studies on this matter either explore the frequency of ritual abuse disclosures to professionals, address allegations of ritual abuse made by children and adults, or investigate suggestibility, rumor, and iatrogenesis as possible explanations for such allegations.

“Religious/Ritual Abuse (RA)” will be used henceforth as an overarching label of any type of abuse or maltreatment which is legitimatized by, and/or occurs under the guise of religion and pseudoreligion including mystical movements and Satanism.

As a result of the psychologically insurmountable nature of their experiences, victims of RA frequently develop Dissociative Disorders, especially Dissociative Identity Disorder (DID; Fraser, 1990; Gould & Cozolino, 1992). Dissociation reflects disruptions in the usually integrated functions of consciousness, memory, identity, emotion, perception, and body representation (American Psychiatric Association [APA], 2013). Dissociative phenomena include both an elevated capacity for absorption and imaginative involvement and the compartmentalization of memory and personality through amnestic barriers. Dissociation can also be decomposed into two subtypes, that is, depersonalization/derealization and pathological dissociation, both characterized by experiences of unreality, detachment, or being an outside observer with respect to one’s thoughts, feelings, sensations, body, or actions (APA, 2013).

RA has been proposed as one, possible, precursor to the type of repressed memories observed in DID, where major parts of an individual’s past is inaccessible due to amnesic barriers (see, for example, Cozolino, 1989; Hudson, 1991; McCulley, 1994; Young, Sachs, Braun, & Watkins, 1991). Throughout the 1980s reports of patients with DID (formerly labeled Multiple Personality Disorder) recalling RA increased dramatically, and these were patients who were already in therapy for repressed memories of childhood abuse (Fraser, 1997). In the following years, a large number of patients with DID undergoing psychotherapy reported memories from early childhood of explicit satanic rituals (Becker, Karriker, Overkamp, & Rutz, 2008; Bottoms, Shaver, & Goodman, 1996; Holland, 1987; Van Benschoten, 1990). Furthermore, different studies (Braun & Grey, 1986, 1987; Ganaway, 1989; Karriker, 2008; Kaye & Klein, 1987) showed that 20% to 84% of DID patients reported histories of SRA.

Survivors of ritual abuse have reported experiences that suggest the presence of cult-related identity fragmentation procedures (Gould & Cozolino, 1992). Alter personalities, often existing outside of the awareness of the victim’s “host” personality, are produced to serve certain purposes. Hence, each cult-created alter is “programmed” to serve a particular cult function, for example, maintain contact with the cult and disrupt the therapeutic process. Fraser (1990) also proposed that DID is produced to consolidate and perpetuate the ritual abuse. That is, older members with DID traumatize new members into fragmentation, without being consciously aware of their invasive actions due to dissociative amnestic barriers.

The relationship between RA and dissociation was given much attention during the 1980-1990s, but in the following two decades, this path of research has, apparently, nearby been neglected: Hardly any studies have been conducted since the year 2000. This lack of continuity is striking and forms the basis for the current study, which aims to explore, in further detail, (a) the prevalence of different types of RA in an Iranian context and (b) the nature of the relationship between RA and dissociation.

Method

Participants and Procedure

Participants were recruited from among university students at the Islamic Azad University, Ardabil Branch. Approximately 240 students, either alone or in small groups, were approached by the first author (unaffiliated with this branch of the Islamic Azad University) who asked them about their interest to participate in a psychological study. If interested, they were given a 51-item, four-section printed questionnaire with a short introduction containing general information of the study and the privacy principles the researchers were committed to uphold. The students were requested to return the questionnaire after completion.

A total of 220 students returned the questionnaire but 20 were excluded due to incomplete and/or seemingly inattentive responses. The remaining 200 students consisted of 100 men (M_age = 25 years, M education level = 15.9 years) and 100 women (M_age = 25 years, M education level = 15.7 years). An even number of men and women, and mean age being the same among men and women, were obtained by, consecutively, monitoring the development of the sample in terms of age and gender. Hence, questionnaires were strategically distributed on a day-to-day basis within specific gender/age-based populations until a sample of 100 men and 100 women with the mean age of 25 was reached.

The study was approved by the Center for Research Affairs of the Islamic Azad University, Ardabil Branch. Participants were not, by any means, coerced to complete the questionnaire. In the general information section, they were ensured total anonymity and informed that their participation in the study was voluntary. Consequently, by returning the completed questionnaire, they de facto agreed to participate.

Materials and Measures

The questionnaire contained the following four sections: demographics, dissociation, history of trauma, and history of RA.

Demographics: There were three general questions relating to age, gender, and total years of education.

Dissociation was measured using the Dissociative Experiences Scale–II (DES-II), a 28-item self-report questionnaire reported to be reliable, internally consistent, and temporally stable (Bernstein & Putnam, 1986; Dubester & Braun, 1995). Participants are required to circle the percentage of time (given in increments of 10% ranging from 0 to 100) that they have the kind of experience described within each item. A preliminary Persian version (first author translation) of the DES-II, with excellent internal consistency (α = .92 in the current sample), was used. Based on the scores on this scale, five types of dissociation were measured in this study:

General dissociativity was measured by computing the mean of the responses to all 28 items.

Pathological dissociation was measured using the DES–Taxon (DES-T) which consists of Items 3, 5, 7, 8, 12, 13, 22, and 27 from the DES-II. A total score is computed as the mean of the responses to the eight items (Waller & Ross, 1998).

Depersonalization/derealization was measured by calculating mean score of Items 7, 11, 12, 13, 27, and 28, drawn from the DES-II (Carlson & Putnam, 1992).

Amnestic dissociation was measured by calculating the mean score of Items 3, 4, 5, 6, 8, 10, 25, and 26 (Carlson & Putnam, 1992).

Absorption and imaginative involvement was measured by calculating the mean score of Items 2, 14, 15, 16, 17, 18, 20, 22, and 23 (Carlson & Putnam, 1992).

History of trauma was measured using the Childhood Trauma Questionnaire (CTQ; Pennebaker & Susman, 2013) which includes two sections: (a) the Childhood Traumatic Event Scale (CTES), containing six items and (b) the Recent Traumatic Event Scale (RTES), containing seven items. A preliminary Persian version (first author translation) of the CTQ was used. Both the CTES and the RTES had very low internal consistency (α = .40 and α = .37, respectively, in the current sample). This might reflect that the scales are sensitive to a broad spectrum of traumatic incidents, of which a large proportion, especially the most severe, was scarcely reported in this particular nonclinical sample.

History of RA was measured using the preliminary seven-item Religious/Ritual Abuse Questionnaire (RAQ; see the appendix). The RAQ was designed especially for this study to detect the main types of abuses (physical abuse, sexual abuse, emotional abuse, and other abuses) that may occur under the guise of religion, pseudoreligion, newly emerged religions, and mystical movements and Satanism. Some examples of RAs were included in parentheses to exemplify some types of RAs which are specific to Iranian culture, like, for instance, punishment by parents due to sin; physical punishment because of refusal to engage in religious/pseudoreligious rites; bodily harmful rites, specific diet of mystical movements; sexual abuse such as rape, harassment, or sexual exploitation; participation in burial ceremonies; being excessively frightened of religious matters; being enforced to act according, to Sharia law and other religious laws; and also insult and/or humiliation under the guise of religion/pseudoreligion (see the appendix).

Design and Data Analyses

Frequencies of reported CTQ and RAQ items were computed. Also, gender differences with regard to history of RA were explored through a chi-square test. Furthermore, Pearson correlations between dissociativity and its subscales, childhood and recent trauma history, and RA history were calculated. Finally, to extract the most important traumatic predictors of dissociativity, Multiple Linear Regression Analysis between single items of CTQ and total score of RAQ, as independence variables, and dissociativity and its subscales, as dependent variables, was performed.

Results

Prevalence of Traumatic Events and RA

About 61.5% of the participants (126 participants) reported at least one childhood traumatic event, 58% (116 participants) reported at least one recent traumatic event, and 6.5% (13 participants) reported experiences of sexual abuse (see Table 1).

Table 1.

Frequencies of Women and Men Having Experienced CTQ and RAQ Items.

CTQ and RAQ Items	Women (N = 100)	Men (N = 100)
CTQ and RAQ Items	Frequency	Frequency
Childhood traumatic event (prior to the age of 17 years)
Death of a beloved person	39	44
Divorce or separation of parents	4	12
Sexual abuse	3	5
Being victim of violence	7	9
Being extremely ill or injured	18	30
Other major upheaval (mostly emotional abuse)	8	18
Recent Traumatic Event (within the last 3 years)
Death of a beloved person	35	42
Divorce or separation from spouse	3	5
Sexual abuse	4	1
Being victim of violence	10	6
Being extremely ill or injured	11	18
Major upheaval in job	6	13
Other major upheaval (mostly emotional abuse)	14	10
Religious/ritual abuse
Physical abuse	0	6
Sexual abuse	0	0
Emotional abuse	7	12
Other abuses	3	2

Note. CTQ = Childhood Trauma Questionnaire; RAQ = Religious/Ritual Abuse Questionnaire.

About 12.5% of the participants (25 participants: 16 men and nine women) reported to have experienced at least one of the RAQ items. Most reports of RA were religion-related abuses (90%), two reports were in relation to magic and one report was in relation to the severe psychopathological consequences of watching a clip of a brutal terrorist act. No histories of Satanism or SRA were reported. As shown in Table 1, among the four main items of RAQ, 19 participants reported histories of emotional abuse, six participants reported history of physical abuse, five participants reported other types of abuses and no participants reported religion-related sexual abuse. A chi-square test showed that there was no gender difference between men and women (χ² = 2.24, p = .13).

Relationships Between RA, Other Traumatic Exposure, and Dissociation

Among 38 participants who scored higher than the clinical cutoff score of 30 on the DES-II, 10 participants reported histories of RA. As shown in Table 2, all correlations between dissociativity and its subscales, childhood and recent trauma history, and RA history were significant, apart from the correlation between amnestic dissociation and RA, which was not. Finally, and as shown in Table 3, being victim of violence within the last 3 years was the most important traumatic predictor of dissociativity. RA was the second most important traumatic predictor of all dissociative measures except amnestic dissociation, where it had no significance.

Table 2.

Pearson Correlations Between Main Variables.

Variable	1	2	3	4	5	6	7	8
1. Religious/ritual abuse	—
2. Childhood trauma	.3289***	—
3. Recent trauma	.2051**	.2901***	—
4. DES-II	.2466***	.3036***	.3175***	—
5. Depersonalization/derealization	.3199***	.2814***	.2961***	^a	—
6. DES-T	.2402***	.3145***	.2699***	^a	^a	—
7. Amnestic dissociation	.0597	.2017**	.2392***	^a	^a	^a	—
8. Absorption and imaginative involvement	.2632***	.2785***	.3005***	^a	^a	^a	^a	—

Note. DES-II = Dissociative Experiences Scale–II; T = Taxon.

Not needed.

p < .01. ***p < .001.

Table 3.

Results of Multiple Linear Regression Analysis.

Variable	B	SE	Beta	t-Statistic	p
Most important traumatic predictors of dissociation (DES-II)
Constant	14.01	1.31	–	10.69	<.0001
Being victim of violence within the last 3 years	10.60	3.31	.23	3.20	.0016
Religious/ritual abuse	4.84	2.01	.17	2.41	.0170
Other major upheaval in life prior to the age of 17 …(mostly emotional abuse)	6.08	2.77	.17	2.19	.0294
Death of a beloved person prior to the age of 17	3.68	1.68	.15	2.18	.0301
Most important traumatic predictors of depersonalization/ derealization
Constant	6.63	1.41	–	4.67	<.0001
Being victim of violence within the last 3 years	14.10	3.58	.28	3.93	.0001
Religious/ritual abuse	8.24	2.17	.27	3.78	.0002
Most important traumatic predictors of pathological dissociation (DES-T)
Constant	8.86	1.34	–	6.58	<.0001
Being victim of violence within the last 3 years	10.54	3.40	.23	3.09	.0022
Other major upheaval in life prior to the age of 17 …(mostly emotional abuse)	6.19	2.84	.17	2.17	.0309
Death of a beloved person prior to the age of 17	3.74	1.73	.15	2.16	.0320
Religious/ritual abuse	4.43	2.06	.16	2.14	.0329
Most important traumatic predictors of amnestic dissociation
Constant	10.26	1.36	–	7.50	<.0001
Being victim of violence within the last 3 years	8.30	3.45	.19	2.40	.0173
Death of a beloved person within the last 3 years	3.24	1.77	.13	1.83	.0682^†
Most important traumatic predictors of absorption and imaginative involvement
Constant	21.91	1.75	–	12.51	<.0001
Religious/ritual abuse	7.52	2.68	.20	2.79	.0057
Being victim of violence within the last 3 years	11.87	4.42	.20	2.68	.0080
Other major upheaval in life prior to the age of 17 …(mostly emotional abuse)	8.25	3.70	.17	2.22	.0271
Death of a beloved person prior to the age of 17	4.91	2.25	.15	2.17	.0308
Death of a beloved person within the last 3 years	4.03	2.26	.12	1.78	.0766^†

Note. B = Unstandardized coefficient, SE = Standard Error, Beta = Standardized coefficient. DES-II = Dissociative Experiences Scale–II; T = Taxon.

†

is indicative of borderline significance.

Discussion

The prevalence of RA in this sample of Iranian young adult college population was 12.5% and the most prominent type of RA was that of religion-related emotional abuse. Examples of such are being frightened of religious matters (e.g., consequences of sin, afterlife, supernatural religious entities, etc.), participation in burial ceremonies and religious rites, and humiliation, insult, and false accusation. Furthermore, RA-related sexual abuse was not reported but three out of six cases of physical abuse were reported in relation to a self-harm behavior known as “Tatbir” in Arabic and “Qame-zani” in Persian. This is a ritual endorsed in some conservative Shia Muslim cultures in the Ardabil area, where the study was conducted.

About 26% of those who had DES-II scores above 30 also reported histories of RA. By taking into account that those who score more than the clinical cutoff score of 30 on the DES-II are highly likely to have dissociative disorders (Carlson & Putnam, 1992), this result is comparable to previous findings of the prevalence of RA among patients with dissociative disorders (Braun & Grey, 1986, 1987; Ganaway, 1989; Karriker, 2008; Kaye & Klein, 1987). In addition, a history of RA significantly correlated with four dissociative measures, that is, general dissociation, depersonalization/derealization, pathological dissociation and absorption and imaginative involvement (see Table 2). Although these findings do not explicitly have any etiological implications, they are in any case reflective of a considerably strong relationship between RA and dissociation.

DID is claimed to be closely linked to RA (Becker et al., 2008; Bottoms et al., 1996; Holland, 1987; Van Benschoten, 1990) and patients with DID who have been victims of RA are characterized by amnestic barriers and repressed memories concerning their history of RA. However, this clinical feature was not detected in this sample. On the contrary, our findings showed that there was no significant correlation between history of RA and amnestic dissociation. One possible explanation for this might be that the sample was nonclinical and did not, by random, include more than a very few individuals with very high levels of dissociativity, bordering to or equivalent with DID. Another possible explanation is that participants with higher levels of dissociative features might not have had access to specific RA-related experiences in their past due to dissociative memory boundaries.

The most notable finding of this study might be that RA is the second most important traumatic predictor of nearly all measures of dissociation (see Table 3). RA is thereby more important than a series of other traumatic events, such as, for example, childhood and recent sexual abuse and intra-family conflicts. The finding that RA has such a central role in relation to dissociative symptomatology is striking, especially when taken into account how little attention RA has been given in the field of dissociation research during the past two decades.

The study has some limitations. First, the generalizability of the results is limited due to the use of self-selection as a sampling method in combination with a relatively small sample of young adult university students and. Second, it must be taken into consideration the inherent risk of producing false-positive associations between variables when using cross-sectional designs, such as the one used here. Third, the authenticity of the reports might have been affected while using a retrospective self-report instrument to measure traumatic experiences, possibly in the direction of artificially lower response rates (Fergusson, Horwood, & Woodward, 2000; Hardt & Rutter, 2004). Most of these limitations may be resolved in future research by using larger samples from various spectrums of the population.

Our study adds weight to the, somewhat, scarce literature of RA and dissociation and might pave the way for a renewed effort to further our understanding of the relationship between these phenomena. The role of RA should be readdressed systematically and more extensively, both with regard to the prevalence of RA and with regard to clarifying hitherto unexplored mechanisms of RA-induced pathological dissociation, like, for example, the supposedly instrumental role of alters in galvanizing the social fabrics of religious cults (Fraser, 1990). Evidently, a more comprehensive understanding in this area among clinicians and professional caretakers might both lead to more precise therapeutic interventions, and most importantly, to early detection of RA through the ability to read and interpret the emergence of dissociative symptomatology within the context of, and in view of, religious/ritualistic socialization procedures.

Footnotes

Appendix

Author Biographies

Habib Niyaraq Nobakht was born on July 24, 1992, in Niyaraq, Iran. As a particularly accomplished pupil, he was selected to complete his high school education in specialized government-sponsored schools in Ardabil and Tehran. In 2016, he obtained a bachelor’s degree in guidance and counseling training at the Islamic Azad University, Babol Branch. His research interests are psychological trauma and dissociative disorders. In collaboration with Norwegian researcher Karl Y. Dale, he has, over the course of 18 months, performed four studies, of which, one is published, two are under review, and a fourth is in progress.

Karl Yngvar Dale was born on July 24, 1963, in Ålesund, and is a Norwegian specialist in clinical psychology and researcher. He studied at the University of Bergen and graduated as a psychologist in 1989. In 2008, he obtained a PhD degree in psychology at the University of Tromsø. He has clinical and administrative experience from a wide variety of mental health care and substance abuse treatment facilities. He has expertise in complicated traumatic stress reactions, violence risk management, community-based mental health work, and health care organization. He is currently associate professor at Molde University College.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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