Report of the Working Group Ritual Abuse

April 1994
Ministry of Justice
Direction of Constitutional and Criminal Law
Postbus 20301
2500 EH Den Haag
(The Netherlands)
Telephone +31.70.3707198

[Translated by J.W. Nienhuys]

[Explicatory notes will be enclosed in square brackets. Page numbers of the report will be indicated by pointy brackets <0> and a white line; this page number is at the top of the page in this translation.

Words or phrases that are underlined in the Dutch original will italicized.

There is a Dutch word ‘hulpverlener’, meaning literally someone who provides help, and which can have very many meanings, like ‘intervenor’. I have translated it usually by ‘therapist’ or ‘therapists and social workers’, and in the context of children (where remedial educationalists, and various representatives of child protection agencies or medical personnel can be meant) I have often used ‘care’ for ‘hulpverlening’.

In this translation MPD is often used; in the Dutch version this is usually not abbreviated. It means Multiple Personality Disorder.

The translator apologizes for any unclarity caused by crummy grammar, typing errors and so on, but all the same he wants to point out that the Dutch original suffers from poor style as well.

The translator generally refrains from any comments on the contents, except to clarify references or technical details, but wishes to make an exception for one detail. It will be clear from this report that the committee could not say even approximately how many cases of alleged ritual abuse it had studied. ‘A few tens of cases’ was the closest they could get, see page 7. The reason for this was twofold: the extreme caution by the therapists that were interviewed and the lack of any concrete detail. The most concrete detail the committee heard was the affair of the cloth with the red symbols on page 10. The descriptions of the therapists were so vague that it was not possible to match them to specific police investigations. So the committee didn’t know how many cases they heard twice. Possibly this state of affairs his inspired the committee to investigate in detail the legal aspects of the duty of silence and the privilege of non-disclosure.]

CONTENTS

1. INTRODUCTION.
1.1 Backgrounds of the phenomenon of ritual abuse 1
1.2 Reason for the investigation 2
1.3 Formulation of problems and questions to be investigated 4
1.4 Structure of the report 4

2. INVESTIGATION CONDUCTED.
2.1 Method of work 6
2.2 Some case descriptions 7
2.3 Other research 13

3. DEFINITION OF TERMS. 16

4. YOUTH CARE, YOUTH PROTECTION,  MENTAL HEALTH CARE. 26

5. DISCUSSION.

6. PROFESSIONAL SECRECY AND THE PRIVILEGE OF NON-DISCLOSURE.
6.1 Professional secrecy 41
6.2 Oath of secrecy 42
6.3 Privilege of non-disclosure 46
6.4 The law on professions in individual health care 50
7. SUMMARY, CONCLUSIONS AND RECOMMENDATIONS 52
Appendices. 60
1. Police investigation of  ritual abuse.
2. The text of the decision to  institute the Working Group Ritual Abuse.
3. Literature.

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1. INTRODUCTION

1.1. Backgrounds of the phenomenon of ritual abuse.

Reports about ritual abuse have been coming from the US since the beginning of the 80s, American literature shows. >From 1985 on, there is increasingly more attention for the phenomenon, and many conferences are dedicated to the subject (Lanning, 1992).

The cases in which ritual child abuse is mentioned differ in a number of aspects from other sexual child abuse cases. The differences are:

– there are several young victims;
– there is more than one perpetrator;
– fear is used as a means of victim control;
– bizarre or ritual activities.

According to the literature that has been perused, extreme sadistic abuse is mentioned, and the violence is committed by a satanic ‘cult’ that operates in very deep secret. This is alleged to be a group in which several families and different generations take part. ‘Satan’ is revered and in this context the group members are said to indulge in ritual abuse, cannibalism, animal sacrifices, human sacrifices and sexual abuse. Adult socalled ”survivors” of ritual abuse mention the following practices: forced administration of drugs, electric shocks, hypnosis, sexual abuse among which group rape, witnessing live burials as well as experiencing these oneself, threats to life, witnessing and taking part in torturing and sacrificing adults and children (among whom babies), the mutilation and killing of animals. Furthermore is mentioned being married to satan, forced pregnancies, eating one’s own babies, eating human body parts. Most of

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this the victims are supposed to have experienced as young children already. By means of terror the victims are supposed to have been indoctrinated or programmed to keep silent, or to commit suicide if they mention anything about the ‘cult’.

It is reported that both adults and children that are the victim of ritual abuse show complex forms of MPD and other complaints. Boon and Van der Hart (1991) say about this:

[Note. This reference is absent from the literature list. Probably is meant: Hart, O. van der & Boon, S. (1991) Multipele persoonlijkheidsstoornis bij kinderen. In: W.H.G. Wolters (ed.), Psychotrauma’s bij jongeren. Baarn, Ambo. ]

”they suffer even more from the complaints of posttraumatic stress, they are even more fearful, more depressive, and more suicidal than other MPD patients, they engage in more automutilation, they suffer more from feelings of guilt and they run a greater risk to display perpetrator behavior in the dissociated state.”

It is said that psychotherapists, both of children and of adults in The Netherlands and also in foreign countries, are being confronted with comparable stories of patients (Jansen Heijtmajer, 1993).

>From the literature is is clear that since 1985 the police and the Department of Justice in the USA often have investigated on the occasion of many reports of ritual abuse, but that this never led to concrete (provable) criminal court cases (Lanning, 1992). Also in The Netherlands police and justice have started an investigation of reports of ritual abuse, but this has likewise not yielded any concrete results.

1.2 Reason for the investigation.

In 1992 there were reports to the Inspection for Youth Care (IJHV) of the ministries of WVC (Social Work, Public Health, and Culture) and Justice. These reports originated from institutions for youth therapy and social work, and concerned possible ritual abuse of a number of children. Until August 1992 there were about 11 cases in the provinces North Holland and Utrecht.

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In the middle of June 1993 it was reported that there was an increasing interest, caused among others by the TV broadcasts of NOVA.

The IJHV has issued a signal report for the first time to the minister of WVC and the underminister of Justice on September 17, 1992.

After the appearance of this signal report consultations have taken place between the IJHV, the Medical Inspectorate of the Mental Health (GIGV) and the Ministry of Justice, to get a better perspective on the phenomenon, more specifically to acquire insight in the way in which the fine tuning and cooperation during the report and research phase can be established, approached from the child’s interest. In the mixed GIGV working group MPD the subject of ritual abuse and the problems involved between therapists and social workers on one side and police and justice on the other side had been brought up already in the beginning of 1993. On the basis of this the GIGV decided to organize an ”invitational conference” on the subject. After consultation with the Department of Public Health of WVC, the IJHV and the Ministry of Justice, this conference took place on September 17, 1993. During the conference more insight has been acquired into the phenomenon and especially into the problems of cooperation between therapists and police. It was decided to institute a national coordination point Ritual Abuse for therapists and social workers. The GIGV is now starting preparations for that.

The Department of Justice asked two police groups and also the Central Detective Information Service (CID) what they knew about it. As preliminary conclusion this yielded that signals of ritual abuse were known in a number of groups, but that no hard evidence was found. Next all councils for child protection and a number of child custody organisations have been approached with the question whether they had come into contact with the phenomenon. At the request of the Department of Justice the IJHV has supplied the data they had collected in anonymous form. These collected data did not yield useful material for police and justice, so another approach was sought

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to investigate the problem. In the middle of June 1993 the underminister of Justice decided to institute the Working Group Ritual Abuse with as task to define and map out the problems, to investigate the problems that arise when ritual abuse is reported as crime and also, if necessary, propose questions for closer investigation and/or propose reporting procedures. The Working Group was instituted by decree of the underminister dated August 12, 1993 (see appendix 2).

1.3 Formulation of problems and questions to be investigated

As has been brought up above, the reports of cases of ritual abuse to IJHV have been the direct cause for bringing up the question to which degree the problems occur in The Netherlands, which possibilities the civil authorities, the institutions for therapy and social work therein included, have for taking adequate measures and reporting cases in the same framework to the police and the public prosecutors.

The problem should be defined and a survey should be made of all cases that are known to the institutions for social work and psychotherapy and others, and also a survey should be made of the problems there are in reporting or filing criminal charges to the police, also with respect to possible closer investigations and a procedure for reporting. This is the task of the Working Group, as defined in the institution decree (see appendix 2)

1.4 Structure of the report.

The report is structured as follows.
In chapter 2 is described what has been done to investigate the problem, the methods of the Working Group. In chapter

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2 there are also some case descriptions that have been brought to the attention of the Working Group by several therapists and a short report is included of other investigations of the Working Group. In chapter 3 a definition of terms is given, what means ritual abuse. In chapter 4 the aspect of help to young people is discussed, the role of the youth protection and the mental health care. In chapter 5 the different arguments for and against the possibility that ritual abuse occurs are contrasted. In chapter 6 an exposition is given of the professional secrets of therapists and social workers that have to deal with cases of ritual abuse. Finally, in chapter 7 conclusions and recommendations are given. In the appendices is one contribution titled ”Police investigations of ritual abuse”.

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2. INVESTIGATION CONDUCTED.

2.1 Method of work.

The working group has spoken to a number of people, namely therapists and social workers and police about whom is known that they have experience in the subject; the aim was to take stock of the most important cases of reported ritual abuse. Also the Working Group has tried to get information that is as accurate as possible about the phenomenon of ritual abuse. In this connection two members of the Working Group have paid a short visit to a researcher in the United Kingdom of ritual abuse. This is reported in section 2.3. Also were studied police reports and prosecutor’s reports about cases in which ritual abuse is mentioned.

Questions posed.
To the psychotherapists, social workers and remedial educationalists the following questions have been put:
– to which degree and since when have they met these problems;
– in what kind of communities ritual abuse occurs;
– (in concrete cases): what did you hear, what did you do, why did you not report to the police or justice and to which degree the things you heard could be verified;
– do you have suggestions for further research.
To police representatives was asked:
– which concrete cases do you know and in which of those no further investigations have taken place and why did this not happen;
– what are the results of investigation if they were undertaken;

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– do you know cases of criminal prosecution of persons that have perpetrated ritual abuse;
– do you have suggestions for further investigation.

Occasionally some alleged perpetrators or victims of ritual abuse have spoken to members of the Working Group.

The Working Group has thought about the question whether a more detailed and more specific investigation should be undertaken into the ritual abuse phenomenon. This is the subject of chapter 7.

2.2 Some case descriptions

Below some cases are described that are reported by the persons heard.

>From the interviews a few tens of cases were brought up of possible ritual abuse. The first cases date from 1985, but were not recognized as such. Specific symptoms that these patients are alleged to show may be, among others:

– they suffer from MPD.
– they draw pictures with satanic motives, like inverted crosses, altars with pregnant women who have their baby cut out of their bodies;
– a great degree of fear;
– a secret that cannot be shared with anybody;
– strong reaction at certain words, that are apparently code words;
– anamnesis contains serious matters like automutilation and suicidal behavior;

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– around the time of the satanic calendar they have depressions, which is apparent from increased medication. It was said that some patients consistently get a crisis around this time.

According to the therapists these patients tell stories with a great deal of similarity. They do this independently from each other, they don’t know each other. These patients are said to have been abused from childhood on. By means of systematic isolation, torture and terror induction these people are programmed as it were. This is supposed to happen in organizations. Certain places are mentioned where the groups (‘cults’) congregate for their rituals.
The literature from the USA sometimes states that a number of patients says that they have been elected and that they will be activated in the future for a higher aim. A possible explanation for this is given in the literature (Van der Hart and Boon, 1994)

[i.e. Van der Hart and Boon and Heijtmajer Jansen 1994?]

is that the cult of the patient has said this to the patient in order to provide an aim for the cooperation of the patient.
A number of cases reported contained little concrete elements that might indicate ritual abuse. These more speculative cases were left out of consideration.

One case reported by therapists.
A girl was being treated since a short while ago that had been diagnosed as suffering from a serious dissociative disorder (developing MPD). The girl was severely and systematically neglected. The parents were alcoholics.
After assignment to a foster home by the juvenile judge and also strong limitation of visiting rights she felt safe enough to tell/play things.

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It is said that she was taken to certain places and there she would have to drink (among others) blood (of killed babies) and sperm. During the (therapeutic) play about this she showed strong physical reactions. At the same time she played flatly and without emotions, without any affect. Also it was said that she was forced to swallow an eye, and that she was told that she would be ever watched from that time on.
The pattern the girl showed was different than that of other children with extreme fears, especially in the way the story was constructed. A strong similarity was observed with stories and fears of other children of whom it was suspected that they were victims of ritual abuse. Those fears seem to be connected with certain times of the year (like Christmas, summer solstice and so on) and with certain symbols (like blood, candles, inverted crosses, swastikas). Characteristic is therefore a great fear coupled to certain situations. In the observations of these children – also this girl – it must be taken into account that the severe neglect can form the basis of the development of behavior to attract attention or please the adult.
This hypothesis is denied by the girl’s therapist. She said that on the contrary the girl sometimes indicated that she doubted whether she really had experienced certain situations or just dreamt them.
This therapist also pointed out that it often happens that children who are exposed to (sexual) abuse and serious threats if they speak, only dare to speak in the form of ”it is not really true, but sometimes I dream that … ”.

Another case that was investigated extensively by the police is the following.
A 16 year old girl reported ritual abuse to the police that was alleged to have taken place about 10 years earlier. Some years before she had filed charges of incest against her father, but this case was dismissed for lack of evidence. At the time of the charges her little brother was in the hospital with inexplicable paralysis. According to the

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charges both children had been the victim of mental and physical cruelties. For examples their favourite pets were killed, they had been locked up in a dark place, tied up, they would have received stupefying drugs, they received electric shocks and family members had been threatened with death and the children had been painted with devilish motifs. There had been congregations with a satanic character in a country house. There babies and animals were killed. The girl allegedly was forced to eat the heart of a dead baby. In one of those meetings a girls was alleged to have been killed.
The police investigated very intensively, but in no way it could be established that the charges were veridical.

Therapists point in some cases to striking details, that could lend plausibility to the idea that the reports are not based on fantasy. The following cases are examples.
One patient who was being treated in the closed ward of an institution, had been victim in her youth of repeated serious abuse by her father. This abuse continued also in a later age, is supposed to have happened within a group (a cult) that had her child in its power (actually it was not an established fact that she had a child). At a certain point in time (probably during the night) a package was thrown against the window of the ward in which she lived. It was found in the morning by one of the nursing personnel. In the package there were a photograph of her (purported) child and a cloth on which terrifying (red) symbols were depicted.
Another case concerns a girl who stayed in an institution for remedial education and who showed symptoms that might possibly indicate ritual abuse. She sometimes received by mail bizarre presents from her parents, like a completely torn T-shirt.

>From the information collected is becomes clear that the therapists have difficulty in filing charges with the police or even report to justice, when they meet cases of alleged ritual abuse.

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As reasons the following were given.

– It is usually not in the interest of the patient to file charges.
– Patients suffering from MPD are often in such a mental state that they are only after many years able to make statements about the delicts that victimized them.
– The victim thinks that s/he hirself is also guilty of ritual abuse.
– Therapists have problems with their oath of secrecy (this will be discussed in chapter 6)
– Therapists are sometimes inclined to think that filing charges of ritual abuse makes no sense, because police and justice don’t do anything about it. – Finally the therapist may be afraid of threats by the group to which the victim belongs.

Furthermore it has appeared from the information of the therapists that were heard, that in many cases the story of the clients that said they were or had been victims of ritual abuse, was established piecemeal. Moreover the ‘story’ consisted partly of direct information about certain events and partly of information in the form of certain signals or the use of certain symbols. This means that in many cases the therapists have played an active role in the construction of the story.
It is striking that almost all reports of ritual abuse that the Working Group has heard from therapists come from a limited number of therapists.
For this one may think of a number of explanations.

One explanation is that these therapists are more able than others in generating this information in the client, in ordering the pieces into a story on ritual abuse and interpreting the information. Generally speaking, it is not exceptional at all that a new phenomenon, especially

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when it is new and rather unknown, can be seen by a limited group of experts.
Another explanation is that especially because the therapist is more strongly focussed on this theme, his or her role in the construction of the story becomes so large that it is not clear, to say the least, whether the eventual story is mainly the result of the activities of the therapist or that it refers to events that really have taken place. This matter will be discussed in chapter 5.

In the above it should be observed that it might be for therapists very important to establish that the patient’s account is factual, but that this is done in a different way than is necessary to do for the police and justice, when they want to prove penal offences. In therapy and social work the subjective experiences of a client are at least as important as the question of the factual basis of these experiences. However, a therapist needs knowledge of the facts to estimate the relevance of the subjective experiences for the assistance that must be provided. So the therapist collects and orders data and judges them according to their relevance for the therapy. In criminal law facts are collected and examined for their penal relevance. This difference can make that what is relevant for one, can be irrelevant for the other, and that the significance for any single fact may differ for both.

Consequently a common aspect in the information the therapists gave to the Working Group was that until now little attention was paid to validating the stories of the patients. A number of therapists said that – after they at first had been sceptic of stories of ritual abuse – after they had heard and seen their patients, they had to assume that ritual abuse actually happens. However, this view did not rest on verified facts.

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2.3 Other research

Members of the Working Group heard that in the UK a research is going on into ritual abuse affairs in England and Wales. This research is done by Bernhard Gallagher (Department of Social Police, University of Manchester). Two members of the Working Group visited Bernhard Gallagher on February 8 and 9. He has extensively reported about the results of his investigations and the two members of the Working Group have examined his data in rough outline. From this the following becomes apparent.

Research
In 1992 an inquiry was held to find out about the prevalence of ‘organized and ritual abuse’ in England and Wales. This investigation was led by Gallagher and Jean La Fontaine (London School of Economics). All this was mainly paid for by the Department of Health. Gallagher’s angle was mainly ritual abuse, La Fontaine’s was organized abuse. All police departments and all social service departments received questionnaires. All police departments cooperated, among social service departments the response was 68 percent.
Gallagher concentrated on recent cases in which children were involved. Cases of long ago, told by socalled adult survivors were not a subject of investigation. From the answers 211 cases were found that possibly fall into one of two categories. Among them were 62 cases of alleged ritual abuse.
Next the files were examined in eight police districts. The choice was done such that they were geographically spread over the whole of England and Wales, and that both urban and rural areas were represented. These eight districts contain together about 7 percent of the population of England and Wales. In this research all available files were examined.

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This yielded 6 cases of alleged ritual abuse and 68 cases of alleged organised abuse. Translated into national scale this would mean 80 cases of alleged ritual abuse and 1000 cases of organised abuse in 3 years.
In the files 5 cases were found that were not reported in the national poll. Hence it appears that a great number of cases were not reported.

Results.
In the research by Gallagher there is the problem too that it is difficult to establish what are the hard cases and what are the soft cases. Out of all reported cases there are only six in which ritual abuse is credible.
Among the ‘organized abuse’ there are three that have been prominent both in a closer investigation of the Metropolitan Police in London (investigator Michael Hames) and in the part investigated by Jean La Fontaine.
Gallagher is still working on further analysis. He selected nine cases for this. His preliminary analysis showed that there are no cases that show ritual abuse in its most extreme forms. In ‘true’ ritual abuse the rituals in the crime are part of a belief system. In the investigations one found all kinds of serious abuse of children by groups. In 70 percent of the cases (of the file search) it is abuse in which groups of both adults – among which the parents – and children are involved. The remainder of the cases is mainly about pedophilic men that abuse boys (sex rings). Among the latter there was a notorious case involving the murder of three boys.
In group abuse a number of the cases has ‘games’ or ‘dressing parties’ that one might call ceremonies, depending on one’s point of view.

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‘Adult survivors’ were not part of the investigation, but the phenomenon was found. The phenomenon of wild accusations happens mostly in that group, according to the investigators. The ‘adult survivors’ are assisted in many cases by support groups for traumatised victims. There have been found twelve cases of women that uttered fargoing accusations, which could not be supported by closer examination. In a number of those cases all dignitaries in the neighborhood were indicated as participant.
Fantasy and truth appear to be difficult to separate in those cases. One case is known of a woman who automutilated and revealed this as evidence of abuse.

The investigator also found a satanic church or society. But a relation between that group and satanic ritual abuse could not be made.
The cases discussed by the investigator strike by the fact that in almost all cases the persons come from a low social class or marginal groups. Only one case is in the middle class. In almost all cases we see strictly religiously orthodox families.

Preliminary conclusion.
On close analysis Gallagher cannot exclude that in one case the elements of satanism and group abuse with certain ceremonies may come together. The Working Group has the impression that satanism or another belief system do not form an essential or necessary part of extreme abuse, with or without group structure.
When one considers the great number of abuse cases that the investigation has yielded, then the attention for a possible ritual aspect seems out of proportion.

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3. DEFINITION OF TERMS.

Accusations of ritual abuse take several forms. In the most extreme version there are stories about an international organisation of men and women that perform rituals in which victims – child and adult – are sexually abused, in which animal and human sacrifices are performed and in which the participants are brainwashed. Moreover those organisations would extend over several generations and the victims are gradually trained in the role of perpetrator. In some stories the abuse is committed for sexual lust, in others it is part of the ritual. In some stories perpetrators and victims are all part of one organisation, in others child porno is mentioned as well as child prostitution.
The accusations come from two sides: children and adults. In children the abuse usually is supposed to be recent, but in adults the abuse took place longer ago. In both cases it is characteristic that the victims rarely complain immediately and file charges, but that before the charges long lasting therapy takes place, and that the therapists are involved in the charges.
Neither in our country, nor elsewhere it has been established that the events mentioned in stories about ritual abuse really happened (for the U.S. see Lanning (1992) and for England see Boyd (1991). When one gives a description of the term ‘ritual abuse’ one only has the stories of the people that were involved, and of course one has the literature in which these stories can be found and in which these stories are discussed more in general. With ‘people involved’ we mean here victims as well as perpetrators. Perpetrators that tell about

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their acts, usually say that they were victims themselves when they were children.
Below we first try to get to a definition of terms, based on the literature and the statements made to the Working Group Ritual Abuse. This implies no commitment to the question whether the events in those stories took place or not. Next we discuss a number of hypotheses about the occurrence of ritual abuse. The basic principle for the Working Group is that there are people who more or less clearly report that they are or have been victims of ritual abuse, and that they want to be taken seriously. The same holds for therapists that often don’t know what to do about the stories of their clients.

Characteristics of ritual abuse

The stories of people – children as well as adults – that say they have been victim of ritual abuse have a number of elements in common. Firstly these elements will be discussed. Then a formulation will follow of what is in the view of the Working Group the most characteristic in the stories about this form of abuse.

The victims

The victims say usually that they have become victim of ritual abuse on a very young age. In an examination of 19 cases of ‘organized abuse’, taken from a set of 290 that were treated by the English organisation NSPCC, it appeared that that children that were reported as victim of ritual abuse were younger than victims of the two other forms of ‘organised abuse’, to wit: networks and child porno (Creighton, 1993). Victims of ritual abuse are also on average younger than

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children that are victim of sexual abuse of a non-organised nature (Creighton, 1992).
Victims say they have been witnesses of even babies as object of ritual sexual abuse. Once they became victim on a very young age, this form of abuse allegedly would have gone on for a number of years. Mostly there is a family relationship between the child and some of the adults involved. Given the young age of the victims this is not surprising. It also happens that one changes role after a number of years and that one becomes perpetrator of ritual abuse oneself. Children are also forced into the role of perpetrator.

The nature of the abuse

In the stories there is a combination of physical violence, sexual abuse and mental terrorism. The physical violence can take such forms that it must be called torture. For example there is pain administration by means of electrical shocks. Children witness the slaughter of animals and the killing of foetuses. The sexual abuse is in every form and perversity. Mention is made of drinking blood and consuming excrement and urine. The mental terrorism is intricately connected with the sexual abuse and physical violence. Also there are very grave threats if the victim would tell others. So it is clear that the stories contain much more than only sexual abuse.

The perpetrators

In ritual abuse there is always multiple abuse, namely several perpetrators and several victims. The perpetrators are always adults – men and women -that operate in

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an organized context. From data of Creighton (1993) it appears that in ritual abuse there are more women involved than in other forms of ritual abuse. Often local dignitaries are part of the group.
Sometimes the children are forced to take part in the practices of violence and sexual violence, which according to their statements evokes in the long run a feeling of being an accessory.

The organisation

A characteristic of the stories of ritual abuse is the organised character of the abuse. This is revealed by the use of rituals, the existence of a hierarchical structure within the group, and the use of a certain calendar with dates that are important for the group and in strong checks on secrecy.

The rituals

The abuse and the group meetings are surrounded with a set of rituals. These take different forms: special clothes for adults, spells, secret language and strange symbols, sacrificial rites, altar rites, a holy book, generally matters that call forth an atmosphere of occultism. In the literature therefore often is referred to satanic abuse, which means that the rituals refer to the presence of Satan. Using the rituals helps establish the idea within the group that the leader have supernatural powers.

Causes and effects

In the above the most important elements of the stories about ritual abuse are told. The elements in the stories

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of ritual abuse that have just been summarized all have occurred by themselves in the past: there are international organizations with evil intents; children are sexually abused; theer are sects that perform satanic rituals; there are cases in which multiple perpetrators abuse multiple children; there are cases in which children are horribly abused and there are cases in which babies are murdered.
Typical in stories of ritual abuse is that all those elements or almost all of them are told in combination. When all these elements come together, it gives therapists and police a feeling of recognition: these cases occur, then why not in combination? Nonetheless, there has never been in a ritual abuse case, sufficient evidence separately from statements by the victim. The above descriptions of the most important characteristics are therefore based on the communications of people that say that they are victim, and of their therapists. No statement can be made about the actual existence of this form of sexual abuse, let alone about its prevalence.
A serious complication in judging the truth contents of these stories is that they are told by patients with a seriously disturbed personality structure. This sometimes manifests itself as MPD. Characteristic for MPD is, according to DSM-III/R (Diagnostic and Statistical manual of Mental Diorders, see APA 1987), a disturbance or change of the normal integrative functions of identity, memory or consciousness. It would be incorrect to reason that given this serious disturbance there must be a serious trauma of the kind as told by the patient, when these stories are not verified completely. It would be equally incorrect to reject the stories of these clients as untrue, because they are only the product of a disturbed mind. All these things cannot obscure the fact

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that if someone has experienced things as described above, the chance that serious distortion of personality is almost inevitable.

Fear

The stories of children and adults that say that they are or have been the victim of ritual abuse, and also the stories of therapists about these persons are not only stories about events, but also and maybe especially they are stories about what it means for someone to be victim of such events. To be able to describe the nature of ritual abuse better, it is necessary to address the question what the consequences can be for a child that is the victim of this. The Working Group thinks it therefore important (even though there is massive lack of verification of the stories) to pay attention to the way the literature describes the consequences of these events for the victims, all the time while realising that it is not a priori evident which events formed the basis of these ‘consequences’.
Fear is a crucial element in the stories about ritual abuse. Common in all stories is that this fear is of an unprecedented intensity; unprecedented when it is compared with the fear of victims of other forms of children abuse. The fear is supposedly not only a direct consequence of the horrors experienced by the victim, but also by the most severe sanctions that are threatened if the secret is violated. Being witness and victim of gruesome and for a child uninterpretable events and the fear that is caused by that, would result in depriving the child from its fundamental ability to trust the reliability of its own perceptions, cognitions and emotions and to rely on others. Persons that say that they are victims of ritual abuse are, as said, without exception people that have been psychologically damaged severely.

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The following can be added. In comparison with other forms of abuse it is striking how much impression this fear and confusion makes on the person to which the victim discloses his secret – mostly a therapist. Sharing this secret means that the therapist feels responsible to protect the victim or others against these horrors. At the same time there is the powerlessness to bear this responsibility. This powerlessness is connected to a number of factors: the special stress on the necessity of of secrecy because of the disastrous result if it would become apparent that the victim has broken silence; the difficulty, partly because the stories are so confused or incomplete, to get an insight into concrete places, times and persons; the fact that the role of the therapist is sometimes not compatible with the role of the person who checks the story of a client.

Definitions

In the discussions on the best definition of ritual abuse the question is which of the above elements are the most typical, in other words the question in which respect the stories about ritual abuse differ from other forms of sexual abuse of children.
When one examines the stories that are used or proposed in the literature then it becomes apparent that they vary in the degree in which a specific characteristic is stressed (Lloyd, 1992). In the literature much emphasis is laid on the ritual, the occult and the satanic nature of the group meetings. In the degree in which this aspect is considered more specific for this form of sexual abuse, this aspect will be part of the definition.
Then one must choose to couple the aspect of the ritual more or less with the grouplike and organised character of this form of sexual abuse, or with the cult-like, occult or satanic character of it. In this way one can also more or less

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emphasize the organisational (fixed places, times, rites, persons) aspect of the abuse, or the aspect of physical violence or that of sexual abuse.
If in a definition is chosen for one definite slant, then one meets the problem of the differential nature of the definition. If the organisational nature is stressed, the question rises in what respect this form of organized sexual abuse differs from other forms of organized sexual abuse. La Fontaine (1993) describes organized abuse as ”abuse by multiple perpetrators, some or all of whom are outside the immediate household of the victim(s), and who act together to abuse the child(ren)”. [quote is verbatim, i.e. in English]. Socalled networks of sexual abuse in which adults cooperate in sexually abusing children and child pornography also are comprised in such a description. Kelly (1988) stresses the element of the ritual and arrives at the following description: ”the repetitive and systematic sexual, physical and psychological abuse of children by adults as part of cult or satanic worship.” [quote is verbatim, i.e. in English]. Here the accent is strongly on the cult-like character, but the horrible nature of the abuse and the perversity of it are not considered in such a description.
In the stories the rituals are more than just bizarre frills. They form part of the alleged organised character of this form of sexual abuse, in the sense that they – like all group rituals do – strengthen the bonds between the groups. Also they amplify the mysterious and secret character of the meetings, and therefore increase the pressure to keep them secret. On the other hand they are terrifying, especially because some rituals have the form of physical violence, like the killing of animals. The rituals themselves should not be considered as innocent or at most bizarre.
The organisation of the abuse and the therefore almost implicit character of multiplicity of perpetrators is not the most differential characteristic. The rituals in themselves are also not. The stories do not concern sexual abuse with a bizarre and occult trimmings. The most characteristic of the stories

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by which they distinguish themselves from other forms of sexual abuse is their gruesome character, a perverse sexual sadism.
This view finds support in the literature. Jones (1991) mentions the following three aspects that all clinical treatises on this subject have in common. Firstly the embedding of sexual abuse in a usually deviant belief-system, for example satanism. This framework has by its extravagance a disastrous and deep influence on the personality structure, the attitudes, the opinions and the bondings to others of the victims. In the second place he points to the combination of sexual abuse with the planned and sadistical character of the activities which has very serious psychological consequences. In the third place there is the combination of sexual abuse with extreme humiliation and dehumanisation of the victim, which has disastrous consequences for the confidence and selfrespect of the victim. In other words, it is the combination of on one hand the extravagant belief-system, the systematically planned sadism and the extreme humiliation with on the other hand the disastrous effects thereof on the personality structure, which is so characteristic for this form of sexual abuse of children.
Finkelhor, Williams and Burns (1989) emphasize what they called ”the identification doctrine that celebrates participation in intentionally evil acts” (p. 64) [quote verbatim, i.e. in English]. They point to two important elements in the combination of rituals and sexual abuse. The first is the destruction of the development of the (sexuality of the) child. They suppose that the perpetrators have experienced their own sexuality as corrupted and evil and demonic, and that they shape their resentments by destroying (the sexuality of) an innocent child. The second element is is the identification with evil. The supposition is that such perpetrators invert their value systems in order to defend themselves against normal

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human needs. In other words, because of the corruption of the own humanity the corruption of the others is made into a system that rejects humanity. The own impotence to give shape to one’s own humanity is in this way transformed in a feeling of superiority over moral and finally over others.
Finally, Sakheim and Devine (1992) write: ”a focus on the mystical and sensational aspects of this phenomenon can distract us from the sad reality of the extreme sadism and cruelty truly behind the problems that these patients experience.” (p. xv) [quote verbatim, i.e. in English]. This combination of unprecedented sadism and occult practices make the story of the victims into something unimaginable. As a consequence one is as well occupied with the question of the credibility of these stories and of the storytellers, as with the stories themselves. Nonetheless it would be wrong to reject the stories as incredible just because of their unprecedented cruelty. Perverse sexual sadism with respect to children is not an unknown phenomenon. Without wanting to commit itself to statements about the credibility of the stories, the Working Group has tried to understand through the above analysis what are the most important common elements of all these stories. There are many descriptions and definitions of the concept of ritual abuse available in the literature. Not to add again a definition of their own, but rather to render the core of ritual abuse, and also as further guideline for the activities of the working group, the above provides the grounds to describe ritual abuse as

sexual sadism, surrounded by rituals, and performed in groups against several children in combination with extreme forms of physical violence and threats.

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4. YOUTH CARE, YOUTH PROTECTION, MENTAL HEALTH CARE.

Sometimes among therapists in the sector of youth care a suspicion arises that a child is or has been victim of ritual abuse. Almost always these children are living in an institution. From reports to the IJHV the following can be deduced. On the moment that these children were placed in these institutions there was no suspicion of ritual abuse. The caretakers that applied for a place for these children in the institution did mention serious neglect and mistreatment. Related to this is the fact that in half of those children the placement was ordered as a child protection act. In a number of cases such a child protection decision was formalized after the child had been institutionalized.

When the children were suspected to be victims of ritual abuse, this suspicion arose after they had started to live in the institution. Generally it is very common that during the stay of the child in the institution new information about the child and its backgrounds becomes available. This is necessary to make the right choices for adequate help. One of the central questions is the manner in which the relation between the child and its parents can be repaired, if such a repair is desirable at all. It is necessary that therapists have a good picture of the child, its case history and that of the family where it comes from. So lots of information concerning the child is gathered in various fashions, for instance about its behavior in a group, in therapeutic situations in school and at home.
During this process of information gathering it happened that concerning a number of children a suspicion of ritual abuse grew. In case of the children concerned,

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this suspicion was based on a number of striking things, the most important of which are: automutilation, extreme fear, sometimes coupled to certain dates, obsession with violence, sometimes sadistic violence, a high degree of inpredictability of the behavior, the impression that the child on one moment was quite a different person from the next moment, strong mood changes, and sometimes indications of a dissociative disturbance. The supposition that such an extreme desorientation of a child (which is by the way not in each child the same combination of behavioral characteristics) is basically caused by extremely serious events, the knowledge of relations mentioned in the literature between these extreme behavorial characteristics and ritual abuse, the specific fears and obsessions of the child with matters of a violent and sadistic nature can together raise the suspicion that the child concerned has been the victim of ritual abuse. As an aside it must be remarked that in so far as the Working Group can determine from the data it has available, in none of the cases concerned ritual abuse has been objectively determined other than from the behavior and manifestations of the child.
Of course, in the case that serious behavioral disturbances in a child are observed, a very careful differential diagnostic is necessary. But even then it can appear as if the experience of ritual abuse is the only possible explanation of this extreme unbalanced behavior of the child. In that case the therapists and social workers face the question what weight can be attached to this suspicion as argument for measures to be taken that aim at protection of the child in such a way that the chance of repeated exposure of the child to this form of violence can be excluded. A possible initial plan to rebuild the relations between parents and child loses its self evidence.
The problem here is not specific for this situation. Also in case of suspicions of other forms of violence, like sexual abuse by parents or caretakers, one usually faces the question what weight can be attached to those suspicions

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to take measures that aim at preventing a repeat of the conjectured sexual abuse. But as ritual abuse is a very serious matter, a careful answer to this question is very urgent. To this can be added that one can have reasons to think that other children are victim too of the same abuse.
On the one hand this increases the pressure to tell about their suspicions to the Child Protection Council or the police, on the other hand there is the fear for reprisals if the perpetrators of the ritual abuse would find out that there are suspicions of this around a certain child.
Uncertainty about the solidity of a conjecture of either ritual abuse or other sexual abuse and the justified worry about the possible disastrous effects of such experiences for a child can make that there is need for a maximally accurate clarification of facts. But, as has been argued elsewhere in this report, we have here too that in therapy and social work and youth care, unlike in criminal law, the primary concern is not to establish facts, but to establish an adequate picture about the quality of the educational situation of a child and about the chances a child has in that situation to realize a better perspective of the future. Verification of a suspicion of ritual abuse is not the first priority in therapy and youth care. The first priority is in the examination of the question which degree of safety and what chances for a favorable development exist for a child in its environment and which forms of assistance and possibly which measures of protection are needed to improve these chances.

It is the opinion of the Working Group that the rule must be followed that conjectures of ritual abuse should be reported to the Youth Protection Council and possibly also to the Office of Advice Center Physicians for Child Abuse. This

[This Office will be called by the name BVA later on. There it will be explained what this means.]

offers on one hand the possibility of timely consultations about steps to be taken, among which the desirability of a

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report to the police, and about the desired further investigation, and on the other hand the possibility to combine information about one specific child that is in the possession of therapists with information in the possession of the mentioned organisations.
If procedures are followed: report to the Council for Child Protection – possible investigation by the Council – possible requests by the Council – proving by the children’s judge – possibly measures to be taken by child protection agencies, then this offers a number of justitional guarantees for parent and children.

Parents can appeal the judgments by the judge. The family guardian organisation has to account periodically for their actions.
In case a judgement is given that the parents have to be supervised, or a more extensive measure, there are more possibilities than in a voluntary frame to guarantee effective protection. If necessary the contact between parents and child can be regulated. In this way there can be created opportunities to acquire gradually more insight into the nature and extent of the possible abuse in so far as that is necessary for adequate treatment. In case of a measure for child protection (parents under supervision or more extensive) there is also the advantage that the responsibility for the care and education of the child is regulated well. The family guardian or guardian institution must promote the interests of the child together with or in place of the parents. This is also important to guarantee the continuity in the treatment, care and education.

A next point of attention is the most adequate treatment for these children. The provision of help and assistance, regulated in the youth care laws, aims at giving this help as soon as possible, as shortly as possible, and as close to the home as possible. The behavior of the youths concerned leads in the youth care organisations to the observation that a long lasting offer of help is necessary in a family replacement situation that has the functions of a shelter, treatment and education in order to shape the interests of the child to get an own development.

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Existing treatment centers in the youth help organisations are not equipped for this specific, intensive and long lasting treatment that is necessary for these youngsters. Placing these youngsters in the group type of approach of the usual youth help organisations leads to a serious disturbance in the group and jeopardizes the treatment of both the youngsters concerned and the other youngsters in the group. For an adequate treatment there is a need for additional treatment capacity for these youngsters within the existing facilities, augmented by youth psychiatric treatment. National expertise with regard to diagnosis, indications for treatment and therapy is esteemed to be meaningful. The Netherlands Institute for Care and Well-being (NIZW) must play a supporting role in the development of work, as an extension of the work of the NIZW in the field of sexual abuse.

Mental Health Care

Also in clinics for child and youth psychiatry young people are being treated that suffer from serious disturbances, related to long lasting repeated physical, mental and sexual traumatising.
In 1993 a specialistic child and youth psychiatric setting has started for a small number of these children. With some of these children it was assumed that ritual abuse could be suspected when they were admitted. The treatment of the patients concerned will be followed by an evaluation committee. Possibly more information will be available about the background of the problems of these children.

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5. DISCUSSION.

The lack of forensic evidence

Representatives of the police have stated in discussions with the Working Group that reports of ritual abuse receive much attention, but that nonetheless scepsis remains about the prevalence of the phenomenon. Police investigations of reports about ritual abuse have never been able to establish that the accusations are veridical. Cases of gruesome sexual abuse are known, but these always are isolated cases in which the ritual aspect is lacking and in which there are no indications for an organised character of the abuse.
Many stories of ritual abuse contain elements that should form the basis of other evidence than just the witnessed evidence. An oft repeated element is for instance that victims tell about film and video recordings. Such recordings have never been found.
When there is mention of killing babies, one would expect that baby corpses would have been found. Sometimes it is conjectured that baby corpses are so fragile that they decompose so quickly that after a short time no remains can be found, especially in a moist environment. On the other hand there have been found baby corpses of over 2000 years old that could be identified as such, just as well as adult corpses of the same date.
The alleged amount of ritual abuse activities would make the presence of evidence probable. One would expect that unrelated witnesses accidentally would have stumbled into a meeting. That has never happened. That this never has happened is

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sometimes explained by the perfect organisation of the groups that practise ritual abuse.
An essential party of the stories of victims form activities which are aimed at brainwashing the victims. This element of ritual abuse cases poses a problem. The brainwashing would have as consequence that victims do not mention the ritual abuse for years. This indicates that the perpetrators have techniques that go much further and that are much more perfect than what ever has been reported. On the other hand those techniques are not so perfect that the victims don’t start to report the abuse at a certain point in time (see Loftus, 1993).
The above arouses the conclusion that the chance is very small that the stories that the victims tell about ritual abuse are true in ‘full extent’. This conclusion is supported by the CRI [Central Detective Institute, something like Scotland Yard, the FBI or so.] This does not mean that the stories told are altogether false. An element that repeats over and over again in the reports that the police has given to the Working Group is that alleged victims of ritual abuse are often provably victim of ‘ordinary abuse’.

The victim as witness

Many stories of ritual abuse come from adult women that start to tell about memories during therapy. As said before, these are as a rule women that suffer from MPD (see Ganaway, 1991). A smaller number of stories comes from victims that are under age.
In none of the cases reported to the Working Group a victim has started spontaneously at the beginning of the therapy or in its initial phase with a story about ritual abuse. This raises the conjecture that the therapy influences the formation of the story. This impression is strengthened by the answers of the therapists on the question how their clients exactly told the story. It was said that the victim never spontaneously started with the story

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but that in the first stage their being victim of ritual abuse is deduced from their behavior.

There are three possible explanations for the hypothesis that the victims tell stories about ritual abuse that did not take place, or did not happen in the way it was described.

A first possible explanation is that the stories about ritual abuse are a replacement for other traumas. In this explanation the victim uses the ritual abuse story as a defense mechanism by which other, less extreme traumas can be coped with. This could be the case if the victim has been abused for a long time by members of the family. For many victims it is unbearable that the sexual abuse has been committed by their father who would unite in one person the good thing of the parent and the bad thing of the abuser. The fantasy of ritual abuse would solve that problem: the parents are good and the bad things are ascribed to Satan. Ganaway (1991, p.8) writes:

”Structuralization of the fantasy into a satanic ritual abuse scenario with a relatively clear-cut distinction between good and evil aspects of the caretaker might provide the needed logical explanation for confusing experiences, as well as serving a restorative function by allowing the child grandiosely to believe that she is, in fact, suffering the ritual abuse not because she simply is bad or defective, but because she is indeed special.”

[quote verbatim, i.e. in English].

This hypothesis is supported because in many ritual-abuse cases the plaintiffs say that they are being trained for high priestess and that their own father was the high priest. Moreover many cases seem to take place in a strict religious environment in which Satan is the most obvious representative of evil.

In a second explanation the therapy provides the stories about ritual abuse. Research into the influence of post-hoc

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information on witnesses generally shows that witnesses are sensitive to suggestions of therapists. Some people are more sensitive than others (see for example Gudjonson and Clark, 1986). A special category form the patients that were diagnosed as suffering from MPD. One of the factors that would play a role in that disturbance is the great sensitivity of these patients to suggestion and auto-suggestion. If in such a patient the therapist, as has been mentioned, decides on the basis of behavior that the patient is probably ritually abused, there is a non-imaginary chance that during the following therapy the story about ritual abuse is, in principle, induced into the patient. It can also happen that the therapist orders fragments of stories in combination with behavior of his client into a story about ritual abuse.
This hypothesis is supported by the fact that the stories of the victims of ritual abuse show world wide a great uniformity (see Van der Hart, Boon and Heijtmajer Jansen, 1994). There are two ways in which this uniformity can be explained. For one explanation one has to believe that ritual abuse is indeed committed by members of an international organisation and that this organisation is so rigidly organized that ritual abuse is performed everywhere in an almost identical way. A second explanation is that the therapist choses a hypothesis and that the story is created on the basis of that hypothesis.
The problems that are created by therapy are amplified if hypnosis is used. Hypnosis is not without risk, because in research (Putnam, 1979; Zelig and Beidleman, 1981) it has appeared that witnesses under hypnosis are more sensitive to suggestion. This is not surprising because hypnosis is an increased sensitivity to suggestion, provoked by suggestion. In addition, not everybody can be brought equally easy into an equally deep hypnotic trance. Especially those that are sensitive for suggestion can be brought easily into a deep hypnosis. This makes statements produced under hypnosis risky as proof in court. There is of course rather much of a difference between for example the statement of an

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accidental witness of a bank robbery (for instance about a licence plate of a car) and the deposition of a victim of ritual abuse that has been produced under hypnosis. In the latter case the issue is not ‘accidental’ details that might be misremembered by hypnotic suggestion, but a whole episode would have to be implanted into the autobiographical memory of the victim. This seems only possible in persons that are extremely sensitive for hypnotic suggestion (see Kanovitz, 1992). Victims of ritual abuse, certainly those diagnosed as MPD, belong probably just to that group.

A third possible explanation for the genesis of the stories about ritual abuse might be the well known urban legends. It has been pointed out before by Mulhern (1991) that the stories about ritual abuse show the characteristics of these so called urban legends (monkeyburger stories, see for a description of urban legends Brunvand (1983, 1984, 1986) and Burger (1992)). In this explanation the stories about ritual abuse are an epidemic form of story telling that spreads itself through a network of therapists and victims (Burger, 1994; Frenken, 1994). A support for this explanation might be that the stories about ritual abuse seem to spread unchecked: started in the beginning of the 80s in the U.S.A., after that towards the end of the 80s blown over to England, and arrived in the beginning of the 90s in The Netherlands. It cannot be excluded that the three possible causes of stories about ritual abuse are simultaneously true and possibly together with other factors. It is important to point out that none of the explanations proposed implies that patients or therapists are not bona fides.
The core of the scientific discussion about ritual abuse seems to concentrate on the question whether it is possible that victims can suppress the memory of ritual abuse in their youth entirely, only able to report about their memories after many years and after intensive therapy (Loftus, 1993).

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The discussion is as yet undecided, partly because scientific research is not very well possible because of practical and ethical problems.
Above a number of facts were mentioned that form the reason that it must be called improbable that the stories about ritual abuse are true in full extent. Next some hypotheses were proposed to answer the question how these stories can be created. Therapists are often confronted with stories about ritual abuse. In those cases each time patients are involved that have been traumatised in a very serious way – by whatever cause – and who need help. In thinking about what help should be given in these cases it cannot excluded that – even if memories of ritual abuse are completely or partly incorrect -some, many or all the patients that report ritual abuse are or have been victim of sexual abuse, possibly of a perverse or sadistic kind. On the one hand there are reasons for general doubt with respect to stories of ritual abuse in their full extent, on the other hand it would be incorrect to completely exclude a priori the reliability of such such stories in individual cases. The seriousness of such a story is, taking into account the above of course, that in each single case there is enough reason to seriously investigate its source.

The function of ritual abuse for victims.

Even though there are reasons to doubt the truth content of stories about ritual abuse, the victims believe honestly in their story, but they also have doubts. The same holds for the therapists concerned. The question remains how it is possible that so many people are convinced of the truth of ritual abuse, even though the chance that these stories are veridical must be estimated as small. The Working Group has, within the limited time that was to her disposal, not been able to give a unanymous answer to this question.

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Nonetheless an assumption has grown that possibly can throw some light on this matter. This assumption is exposed below. The Working Group has been struck by the observation that in many of the cases in which stories of ritual abuse are being told, there does exist a high degree of certainty that there has been sexual abuse by parents or caretakers. Also it has become striking how one of the central problems of victims of sexual abuse is emphatically present in stories of ritual abuse. This central problem is the question of guilt or innocence, of Good and Evil. Also Ganaway (1991) speaks about the ‘ritual abuse scenario with a relatively clear-cut distinction between good and evil aspects of the caretaker.’ [quote verbatim, i.e. English].
It is generally known that children that are sexually abused often are burdened with questions like: Was it my fault that it happened or that one of the other? Was I good or bad, was my father good or bad. Should I be accountable for what happened or he? (see for an attributional explanation of the phenomenon Lerner (1980)).
Good and bad, guilt and innocence are themes that are present in stories about ritual abuse, and extremely so. The storyteller is in her stories both guilty and not guilty; guilty because participating in the ritual, innocent because she was made defenceless by injections; she was innocent as victim at a young age, she was guilty as coperpetrator when she was older. In the stories the evil is especially present in the perpetrators, in a clear cut way, in the gruesome deeds that are ascribed to them. At the same time moral norms are not applicable to the perpetrators because on one side their behavior is led by Satan, and on the other side they have placed themselves outside and above the moral order. And finally, in the victims that are diagnosed as MPD the conflict between Good and Evil is visible in the partitioning of good and evil between different personalities (alters).
In a talk that some of the members of the Working Group had with an alleged victim of ritual abuse it was striking how much she went into detail about the ritual abuse that had happened outside of the family. At the same time she

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couldn’t say much about the incestuous contact she had had, according to her statements, with her father. The family abuse seemed insignificant compared to the much more serious abuse outside of the family. A similar phenomenon -discussed above – one finds in victims where the parents are named as perpetrators of the ritual abuse; in the story about the ritual abuse the parents can stay good because the evil they did is imputed to Satan.
As a rule the story about ritual abuse is formed during therapy. In whatever way this story is formed, it always seems to have an important role in the progressing therapy. The story of ritual abuse offers an explanation for fears, depressions and non-understood behavior of the victim. The story has a function: ”I am not crazy, I’ve been made crazy!” This offers the victim security in a special way. This security is strengthened if after sexual abuse experiences not the parents but others or Satan can be marked as perpetrator. The function of the story of the ritual abuse for the victim is primarily to externalise the source of the terrifying internal confusion. But it has a price: the fear that there exists in the outside world a ritual organisation that is a permanent threat.
The Working Group thinks that the hypothesis proposed here is plausible, though more so in some cases than in others. The above doesn’t answer the question why some victims of sexual abuse say they are ritually abused and some others don’t. It is also not clear which part of the alleged victims of ritual abuse is sexually abused as child.
If this supposition is true, the stories about ritual abuse form an extravagant but honest try to answer fundamental questions that face children that are victim of those from whom they are dependent. If that is so, then there is even more reason for therapists to be extremely careful. On one side it is not wise if therapists listen to stories about ritual abuse with extreme scepsis, because these stories can

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have an important function for the patient. On the other side unconditional belief in the ritual abuse carries a great risk in it. The client pays as great price for her belief in the ritual abuse the fear that the people that committed the ritual abuse can strike again, so is still not safe.
Both clients and therapists have their own reasons to take the story about ritual abuse seriously, even though they have told to the Working Group about their conflict of belief and doubt. This is reflected in a more general level in the media debate about ritual abuse. There believers and non-believers clash. It is important, because of the seriousness of the matter, that it is determined in general and in each concrete case what is truth and what is fiction. But the debate between believers and non-believers will remain infertile when one concentrates on the spectacular aspects of the ritual abuse story and forgets about the personal history of the person telling the story. There may be reasons to doubt ritual abuse, but that doesn’t mean there are no reasons for worry. Children can be traumatised in such a way that they later seek support in a paradoxical way in stories about ritual abuse.

Conclusions

Recently both children and adults have told about ritual abuse that victimised them. They tell about gruesome rituals, that are, if true, a very extreme form of sexual violence against children. The victims give testimony of behavior that only can be described as pure sadism in an extreme form.
At the same time both in The Netherlands and abroad there is no other proofs for the existence of ritual abuse than the statements by alleged victims. This does preclude that the existence of all disjointed elements of the stories about ritual abuse are known from police investigations.

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However, their combination in the form of ritual abuse, as told in stories about this, has nowhere been definitively verified.
If one assumes the extent and character of ritual abuse as it is established on the basis of the previous mentioned stories to the Working Group and also heard – as rumors -elsewhere by the Working Group, then it is almost impossible that no forensic evidence has been found. There should have been found with high probability at least some technical traces of evidence. But now this is not the case, the Working Group thinks that there is little chance that the stories about the abuse are veridical ‘in full extent’. This conclusion should be amended by three remarks. There are no indications that the stories of victims are the result of bad faith. Secondly the conclusion does not mean that there are no serious and malicious forms of sexual child abuse. Thirdly the Working Group thinks it possible that even if a story about ritual abuse of a victim is not veridical, he or she may be victim of serious sexual abuse or other serious traumatising events.
In the above some hypotheses are put forward to explain why the stories about ritual abuse are told, while not being wholly or in part true. The investigations of the Working Group are not extensive enough to provide any support for these hypotheses.

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6. PROFESSIONAL SECRECY AND THE PRIVILEGE OF NON-DISCLOSURE.

In this chapter attention will be paid to the question in which respect professional secrecy can play a role in handling cases of serious (sexual) abuse. For practical reasons attention will be focused on the medical professional secret. For therapists who are not physician [‘arts’, i.e. a legally protected title], there may be a duty of secrecy that is self imposed by the professional organisation. Whether a therapist is bound to a duty of professional secrecy because of his profession or office (article 272 of the Penal Code) will in last resort have to be decided by the judges in each concrete case.

6.1. Professional secrecy

In medical circles there is often the misunderstanding that a physician has a right to a professional secret. This is juridically wrong. It’s the patient’s right. The professional does not have a right to a secret but a duty, namely to keep silent. The privilege of non-disclosure (see 6.3) he has only in the interest of keeping his duty, namely to protect the secret of the patient.

The oath of secrecy and the privilege of non-disclosure have aspects both of individual and general interest. The legislator has regulated both oath and privilege, which indicates that the general interest is served by a free atmosphere where the patient can ask without restraint for help, and also that in certain situations confidential statements can be made. That is also an individual interest. The legislator has given lower priority to the detection of punishable offences than to the desirability of unrestricted availability of help and that one can speak freely in such situations without fear for criminal prosecution and that one can trust in the confidentiality of intimate information given to

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certain persons.
Professional secrecy knows two aspects: the oath of secrecy and the privilege of non-disclosure.

6.2 Oath of secrecy

The duty to remain silent, as defined in article 272 of the Penal Code, means the duty to keep secret everything that the professional has come to know during his profession. Sometimes this oath of secrecy is laid down in legal rules (lawyer, notary public, physician) but even more often in socalled professional codes. Where there are no legal rules the recognition is allowed only if the desirability of a duty to keep silent is almost generally recognized (Verburg, 1992). The essential ground of the professional secret is found in the nature of the profession, regardless whether it concerns an office, a profession or a legally specified activity. The duty of secrecy always concerns people about whom may be assumed that they can do their professional work only properly if and in sofar there is the certainty that what they come to know while doing that work stays secret.

To whom one should keep the secret

The duty to remain silent is with respect to anybody (family, other therapists and institutions), except to the patient or client concerned and to the judge.
Generally it is assumed in The Netherlands that the oath of secrecy does not have an absolute character, but that there are a number of cases in which the duty of secrecy does not hold, and in which the person with this duty has to the right or even the duty to speak.

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1) In case of a legal obligation, for instance the law on the prevention of infectious diseases, by which physicians are obliged to report some contagious diseases to the health inspectorate.
2) In case of permission of the patient.
3) In case of a conflict of duties. For instance when the physician acquires knowledge about a murder planned by the patient or if the physician knows that the patient is victim of a crime.

Permission of the owner of the secret

The secret is property of the patient, and he or she can as far as his own interests are concerned release the physician from his duty of silence. The patient’s permission must however be completely free, and he must be able to understand the consequences. The physician is advised to tell exactly which data he will give to a third party. When the patient has given permission, the physician will not be punishable ex article 272 of the Penal Code, when he breaks the duty of silence. If the physician is certain that the patient gives this permit on insufficient grounds, then the duty of silence remains. The patient cannot release the physician of legal obligations in so far as these have an aspect of general interest, namely that patients must be able to trust the physicians they turn to.

Conflict of duties

An example of conflict of duties is in the verdict of the Central Disciplinary Committee of 28 Sept, 1972 [reference NJ 1973, 270]: also without the permission (of the parents or child itself), a physician may report child abuse (Doek, 1972).
Some passages of importance in this pronouncement are the following. The position of trust that the physician has in society implies that the judgement of what one’s duty as doctor demands must be left to each individual physician. Physicians are confronted with situations

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in which very subtle factors play an important role. It is hardly thinkable that the judgement about those situations would be the same for every physician in every situation. Hence it follows that the judgement of such situations about what is the physician’s duty in such a specific case, can lead to different results, and that it is not possible to give in a given case a criterium that would hold for every physician. Trust in the medical class doesn’t mean the certainty that a fixed pattern is followed, but the strong expectation that physicians will try to find in each specific case a solution that is as wise as possible. This means that a physician can meet situations that imply a conflict of duties, and then his own insight in the situation and his own ideas about ethics, moral, and society will have to point the way to a solution. The duty of the disciplinary judge that must judge whether a specific complaint is justified, will restrict his investigations to finding out whether the physician has acted in a medically responsible and careful way; for the rest the judge only has to determine whether the physician could reasonably have come to the conclusion that he had to act as he did in fact.
Another example is the Groningen Medical Disciplinary Committee, 28 Nov, 1956 [reference NJ 1957, 366] in which a complaint was declared unjustified. The complaint was against a physician who had warned the police after he had treated a drunk motorist after an accident. If a physician sees that a patient is the victim of a crime, he can – without asking the patient for permission – decide to inform the prosecutor, because otherwise the secret would protect the criminal and not the patient. A physician who notices that a patient is part of a criminal gang, could for instance decide to inform the prosecutor about the existence of the gang. As said above, the professional secret of the physician is not absolute, even though it is protected with guarantees. The professional secret never

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gives him complete liberty to remain passive if his duty forces him to transgress the boundaries of the professional secret. His personal insight into the situation and his own notions of ethics, moral and society will have to point the way to the solution.

Informing the police

Basic rule is that the treating physician (and so the hospital personnel) may not give information to the police, even not about the presence of somebody in the hospital (Leenen, 1988). Patients ought to be able to go to doctors and hospitals without fear for arrest. Secrecy prevails above detection; this is one of the backgrounds for the rules concerning duty of secrecy and the privilege of non-disclosure. Theoretically there can be exceptions to this rule when there is a conflict of duties for the physician. But in such cases the physician should not go to the police but directly to the prosecutor, because the police is obliged to make written reports, so the secret would become public. One can discuss with the prosecutor in which way measures can be taken so that the secret is broken as little as possible. One may not assume that victims of crimes agree to handing information to the police. Treating physicians can sometimes give information to physicians appointed by the police, provided the identity of the person concerned is known to the police. The treating physician should realise that the physicians appointed by the police will have to report to the police. It remains a violation of the professional secret, but in case of a conflict of duties the physician is not to blame. In the matter of information to the police we mention article 160 of the Penal Code which regulates the duty to report crimes and which says that a person having the privilege of non-disclosure, is exempted from that duty.

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6.3 Privilege of non-disclosure

The privilege of non-disclosure, Penal Code article 218, means that one may claim exemption of the duty to answer questions. Traditionally this privilege is held by clerics, physicians, lawyers, and the notary public with respect to the data entrusted to them. Furthermore medical examiners, insurance doctors, and forensic physicians have also a privilege of non-disclosure, but this is restricted, as is their duty of silence. Insofar as their function implies that they may report on patient data to third parties, like their employers, they must also speak about these data to the judge. Personnel that assists them in their tasks have a derived privilege of non-disclosure.

The privilege of non-disclosure can be considered as the reverse side of the duty to keep silent treated above, in the sense that someone who is bound to secrecy because of article 272 of the Penal Code may abstain from giving testimony in court. This privilege of non-disclosure does not hold for criminal process (art. 218 of the Penal Code) but also in civil procedures (art. 191 of the Code of Civil Procedure). The connection with the professional secret also appears from the circumstance that both articles each time speak about people that are bound to secrecy because of their position in society, their profession or their office. In practice this means that an appeal to the privilege of non-disclosure by one of the classical holders of professional secrets will almost always be granted.

Nature and extent of the privilege of non-disclosure.

The judge must determine whether the appeal to the privilege of non-disclosure is covered by the duty of secrecy in any case of requested information.

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As mentioned above the oath of secrecy of the physician extends to anything that he has come to know in the course of his work as physician. His privilege with respect to this knowledge will therefore be legally recognized, in general. For other professions that esteem themselves to be bound to similar duties of silence, recognition by the judge of their privilege of non-disclosure is less self-evident. The judgement of the judge will be influenced by the concrete circumstances of the case and sometimes by how all-encompassing he esteems the action of the privilege of non-disclosure. Also, in case of physicians, it is questionable if the physician can appeal to the privilege if collegiality is at stake. In some cases protection of these values can clash with the patient’s interest. Silence is then only justifyable if collegiality is used to further the optimal administration of health care.

The Office of Doctors at Advice Centers and the oath of secrecy

In 1972 the ”Bureau Vertrouwensarts inzake Kindermishandeling” (BVA)

[Literally: Office of Doctors at Advice Centers in Child Abuse Cases. What these doctors do or don’t will be described below. ”Vertrouwensarts” is etymologically ”a doctor one can trust”, but according to the Dutch dictionary: a doctor to whom one can report suspected cases of child abuse. I will henceforth translate this as BVA-doctor]

has been created, among others to make it possible that doctors can better signal and treat cases of child abuse and still protect their professional secret as well as possible. Informing a BVA-doctor restricts itself to asking advice about an anonymized case. In this form informing the Council for Child protection (or any other institution) does not constitute a violation of the professional secret. The BVA-doctor is not to be considered as a treating physician, but as a medical examiner, and as such he is not bound by the medical secrecy oath. His function is purely to impart the information he received to others. Only in that way he can initiate the required help. The BVA-doctor should give the acquired information to others only with the purpose of verifying the report or initiating help. So the acts of the BVA-doctor should not be judged

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in terms of a possible violation of the medical secrecy oath, but in terms of requirements of carefulness that should be fulfilled. The BVA-doctor can appeal to the privilege of non-disclosure, i.e. to art. 218 Penal Code, when he is called as witness in a criminal or civil case. The judge should then determine whether in that concrete case the BVA-doctor does or does not have to testify.

Is the physician obliged to use his privilege or does he have the license to do so?

The views about whether it is a duty or a license are not all the same. According to the letter of the law, it is a license. In a verdict of March 6, 1987 [reference NJ 1987, 1016] the Supreme Court decided on the request of a patient that wanted to forbid his attending psychiatrist to make a statement to the judge. In this verdict the Supreme Court upheld the Court. This judgement was:
1. The oath of secrecy of the physician is not absolute, a situation can arise in which the interest of truth must prevail above the professional secrecy.
2. the judgement whether such a situation has arisen should first be made by the physician who is called as expert witness.
3. A prohibition to speak is only required if what the physician says to justify his judgement that establishing the truth in the courtroom has priority, cannot possibly support that judgement.
This verdict was in a criminal case, but we can deduce from it that, according to present legal views, a professional, when he is asked to testify as witness or expert, may speak in other cases than an emergency, without being punishable on the basis of article 272 of the Penal Code. In a procedure against a physician for a disciplinary court it is generally accepted that the physician (in closed sessions) cannot use the privilege of non-disclosure.

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Liability for violation professional secrecy

Violation of professional secrecy is in the first place a punishable offense (art. 272 Penal Code). This does not mean that every violation must be punished and will lead [on discovery] to criminal prosecution. Violation of professional secrecy is prosecuted only in case of complaints. The ‘victim’ of this offense must file a complaint. Without such a complaint the prosecutor is not allowed to prosecute. The prosecutor has the authority to drop the prosecution whenever he wants, on the grounds of general interest. This is the so called opportunistic principle (art. 176/2 of the Code of Criminal Procedure). Then, Dutch practice shows that rarely ever a prosecution and a verdict follow violation of art. 272 Penal Code. Still, most keepers of secrets don’t quite like the idea that in case of violation of the professional secret there is at least in principle the possibility of criminal prosecution. Even if one thinks that breaking secrecy is completely justified, a complaint is possible, and the prosecutor just might think differently and start prosecuting. The judge can then decide acquittal, but just the thought of such a procedure may make a physician decide to keep silent, even if speaking would be mandatory from a medical-ethical point of view. Breaking the professional secrecy can be also – in principle – reason to start civil litigation for damages incurred. Testing the breaking of the professional secrecy happens in The Netherlands mainly in the disciplinary courts. The medical disciplinary court judges not only the question whether the legal professional secrecy was allowed to be broken, but it can also pass judgements on any break of trust that is not precisely covered by professional secrecy. For the medical disciplinary court the central issue in the treatment of a complaint is whether the behavior of the medical practitioner constituted a subversion of trust in the medical class. This is the important difference between this procedure and the

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criminal and civil procedure. In medical law the issue is a general interest: maintenance of a high quality of the medical class.

6.4 The law on professions in individual health care

[The law ”Beroepen in de Individuele Gezondheidszorg” (BIG)]

The law BIG replaces all twelve existing rules for professions.
The law BIG does not reserve medical acts to members of a certain profession. The law BIG introduces protection of titles to a small number of professions. If you have a legally protected profession, you may carry the legally permitted title.
A profession can be regulated in two ways: by law or by general administrative rule. By law are regulated (we only mention the ones important here):
– physician,
– clinical psychologist;
– psychotherapist.
For these professions there will be disciplinary courts that should guard and promote the quality of the profession.
The legislator has thusly extended the disciplinary courts, and he wanted to indicate that serious objections to a professional, among which the violation of the professional secrecy and the incompetent use of the privilege of non-disclosure should be tested by a medical disciplinary court.
In this connection one might ask whether the special character of ritual abuse cases justifies the institution of a clause that proclaims immunity for therapists that report. The Working Group does not approve of this. Not only that kind of immunity doesn’t fit into our juridical system, but the therapists who report ritual abuse could have misdiagnosed,

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or even have been uncareful or incompetent. It must remain possible that the disciplinary judge examines this. This institution must judge whether the professional has been a good therapist. A therapist who has been competent and correct should not have to fear disciplinary actions.
The Working Group thinks that a psychiatrist, clinical psychologist or psychotherapist, if these have a more than serious suspicion of ritual abuse, can break secrecy to the police or prosecutor, as part of being a good therapist, and of course in principle with the approval of the patient, if it is the interest of the patient or if the case is serious.
Maintaining the quality of the health care means to an important degree maintaining the quality if the individual health care; this makes it necessary that if therapists break their vow of secrecy, later checking should remain possible.

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7. SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

Summary and conclusions.

a. Method of work
The Working Group Ritual Abuse has oriented itself in the subject, using the existing literature in this country and foreign countries and the results of research in this and other countries. Furthermore the Working Group has investigated to which degree ritual abuse occurs in The Netherlands, which ways and means the government has to react adequately, in this comprised the means of therapeutic care and informing police and prosecutor about cases, partly with a view to possible further investigations.

b. Definition of terms
On the basis of the available literature the Working Group has determined the characteristics of ritual abuse, and has arrived at a definition of terms. It was concluded that fear is a crucial element in the stories about ritual abuse. The most characteristic in the stories and the way they distinguish themselves from other stories about sexual abuse (organised or not) is their gruesome character, a perverse sexual sadism. Taking this into account the Working Group has arrived at the following definition, without wanting to make a pronouncement on the credibility of the stories of ritual abuse:
sexual sadism, surrounded by rituals, and performed in groups against several children in combination with extreme forms of physical violence and threats.

c. Investigation conducted.
To investigate the problem, the Working Group has spoken to a number of people, namely therapists and social workers and police about whom is known

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that they have experience in the subject; the aim was to take stock of the most important cases of reported ritual abuse.
Also the Working Group has tried to get information that is as accurate as possible about the phenomenon of ritual abuse. In this connection two members of the Working Group have paid a short visit to a researcher in the United Kingdom of ritual abuse. Also were studied police reports and prosecutor’s reports about cases in which ritual abuse is mentioned.
In contacts with therapists the Working Group has been told that on this moment there are in The Netherlands several tens of people (children and adults) who have – verbally and non-verbally – indicated that they were victim or had been victim of ritual abuse. The stories of these persons are characterised by existing and observable excessive fears or psychiatric disorders.
In none of the reported cases actual ritual abuse could be shown. From the investigations in England it has become clear that there too it cannot be concluded that ritual abuse happens.

d. Discussion
>From what police representatives have said and from the literature it appears that ritual abuse never was established. There are good grounds to doubt whether the phenomenon occurs actually in the form in which it is described in the stories. If one assumes the extent and character of ritual abuse as it is established on the basis of the previous mentioned stories to the Working Group and also heard – as rumors – elsewhere Working Group, then it is almost impossible that no forensic evidence is found. There should have been found with high probability at least some technical traces of evidence. But now this is not the case the Working Group thinks that there is little chance

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that the stories about the abuse are veridical ‘in full extent’.
A number of possible explanations is given for the generation of stories about ritual abuse. The Working Group does not have indications that stories of victims and therapists are not honest. On the contrary, therapists and their clients are bona fides in what they tell and believe and in both groups doubt and belief struggle for priority. The fact that no provable cases have been demonstrated, does not mean that it has been incontrovertibly proved that ritual abuse does not occur. In any case the Working Group considers it very well possible that there are very serious cases of sexual child abuse but that the question whether this should be termed ritual is less important. The Working Group has pointed out that in a number of cases the ‘improbable or untrue story’ has replaced the ‘true and probable story’ about sexual abuse by parents or caretakers – or other traumatic experiences – during youth.

e. Youth health care, youth protection and mental health care.
The Working Group pays also attention to specific problems of children about whom ritual abuse is reported by youth care organisations. In youth care the most adequate treatment is still being sought. Very careful diagnosis is of great importance. It is clear however, that in a number of the cases there is or has been serious abuse and maltreatment of the children. For the help a long lasting treatment is necessary in a family replacement situation that has the functions of a shelter, treatment and education, with extra youth psychiatric treatment. Existing treatment centers in the youth help organisations are not equipped for this. Treatment of such children takes also place in clinics for child and youth psychiatric care. This treatment is followed by an evaluation committee.

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The Working Group thinks that in case of suspicions of serious abuse or mistreatment there should be a rule that these suspicions should be reported to the Child Protection Council and also the BVA.

f. Professional secrecy and the privilege of non-disclosure.
The Working Group bases its analysis on the medical professional secrecy. This cannot be applied without changes to the situation of all therapists, but the latter do have a professional secrecy based on their professional ethics. Professional secrecy has two aspects: the duty of silence and the privilege of non-disclosure. It was concluded that the duty of silence is the ”property” of the patient or client and not of the therapist. The duty of silence is not absolute. A number of circumstances can necessitate the breaking of silence. This can happen when the patient gives permission or in case of a conflict of duties.
The judge can test whether one can appeal to the privilege of non-disclosure.
The BVA is created to signal and treat cases of child abuse while protecting the professional secrecy in a responsible way. About cases the BVA’s advice is asked in anonymous form, so this does not constitute a violation of the professional secrecy.
Finally the law BIG is discussed. Under this law disciplinary courts will be created for clinical psychologists and psychotherapists. The breaking of professional secrecy can be tested in these courts.

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Recommendations.

General.

1. The Working Group judges that there is reason to create a Council, given the seriousness, the problems felt, the pressure these exert (therapists suspect, for whatever reason that client are victim of serious perverse sexual sadism, and these clients show serious psychological damages, to whom the provisions of the regular therapy do not seem to apply). This is especially important to follow the developments (included literature and research) closely, especially also in practice.
The work of the Working Group would have to be as it were continued for a certain period, such that it is possible to make the necessary connections between the stories of the victims and the actual performance of investigations by BVA-doctors, Child Protection Councils, police and justice.
The accumulation of knowledge and experience in this field can serve the help to victims and a more permanent possibility for consultation can be a support for therapy.
The Council can improve the necessary cooperation between therapists on one side and police and justice on the other side to effectuate an adequate reaction to reports of cases of ritual abuse. The concrete methods of work and the tasks have to be filled in by the institution of the Council.

Youth care and youth protection

1. For the children with the behaviors described there is as a rule a need for a long term help in a situation that replaces normal family life, with functions of shelter, treatment and education, in order to give form to the interests of the child in a development of its own. The type of help will have to be adapted to this.

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2. For keeping a good survey it should be encouraged that alleged ritual abuse is always reported to BVA. The Working Group points to the conclusions of the Report of the Committee for sexual abuse of juveniles (1994) in which a report protocol is proposed to be followed by professionals that meet (in their professional activity) the suspicion or hard evidence of sexual abuse. Such a behavioral code of reporting, in which reporting is first done to BVA, should be part of the professional code of the different professions involved.
The Working Group advises that arrangements are made between the BVA and the Child Protection Councils about a good way of signaling alleged ritual abuse.
The reporting can take place without approval of parents or children. Therapists should in all cases determine who is the owner of the secret they try to protect and whose interest they serve by remaining silent. It is very important that the person with the duty of silence should realize that the oath of secrecy has no absolute character, and that in some cases speaking is mandatory. In the case of a conflict of duties, which can arise if the therapist knows that patient is victim of a crime, speaking out can be necessary after a careful weighing of interests. But where therapists break their silence, there should always be a later possibility for examining their actions.

Police

As will appear from Appendix 1, and as has become apparent the past years for several times, the justicial investigation of sexual child abuse and more specifically ritual abuse, is far from simple. This type of investigation demands specific knowledge and expertise, among others in the field of hearing the victims. Until a short time ago many police departments had for this a special section for youth and vice cases. Within these sections there was a clear accumulation of knowledge and experience.

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A number of detectives has for instance taken the courses in these fields in the Detection School. As a consequence of the reorganisation of the Dutch police this development seems to have stopped. Many sections of youth and vice affairs are discontinued and their tasks have to be performed by the basic units. This increases the chance that the Dutch police will be less able than before to handle cases of (serious) sexual child abuse. The Working Group deplores these developments and proposes that youth and vice sections in police departments will remain or be reinstituted.

Research

The Working Group has not been able, among others because of the limited time available, to systematically investigate in detail all cases of suspicions of ritual abuse that are known among therapists or justice. This concerns as well children around whom such a suspicion exists, as adults that say that they have been victim of ritual abuse as child. Therefore there is a lack of insight in the backgrounds and characteristics of alleged victims, in the way the suspicion arose, and the way several institutions reacted to these suspicions, and what the result was. For instance it is not clear to which degree alleged victims of ritual abuse have been as child victim of other traumatic events and in how far this possibly played a role in the genesis of a story about ritual abuse. It is likewise not clear how during a process of therapy a ritual abuse story comes into existence and what is the share of the therapist and of the client.
The Working Group realizes very well that it has not said the last word about these affairs. She recommends that more investigation will be done to bring more clarity in these matters and to stimulate that the debate about ritual abuse

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is given a more empirical basis. This is of great importance for the clients and therapists concerned because it furthers that the problems are handled in a balanced way.

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APPENDIX 1.

1. Police investigation of ritual abuse.

Introduction

The approach of the police in ritual abuse accusations is different from that of the therapists. For therapy the interest and the subjective experience of the patient is most important. The police must collect statements and facts that can form the basis of a successful prosecution.

Detection work in ritual abuse cases

It has been mentioned before in this report that it cannot be excluded that statements by victims contain a mixture of fact and fiction. This does not contribute to making detective work easier. The representatives of the CRI pointed out to the Working Group that there have been made errors in the investigation of ritual abuse accusations. This is caused by the fact that these investigations are very complex, by the fact that the witness often is diagnosed as MPD, and by the fact that statements often are about events that are supposed to have happened long ago.
These problems are no reason to brush aside complaints about ritual abuse. At the same time it must be seriously considered that even if the stories of the victims are not completely true, they may contain a nucleus of truth and that nucleus may indicate serious punishable offenses. Practice shows that the bizarre stories that are told sometimes induce detectives to consider them rather

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uncritically as true (‘No person could make this up!’); in

[Here a footnote refers to the New Yorker articles of Lawrence Wright. These are lacking in the list of literature. Since the publicatioon of the report these articles have been published in expanded form as a book, both in Dutch and in English: Lawrence Wright, Remembering Satan, 1994]

other cases those bizarre parts are reason to not do any serious investigation at all (‘This kind of bizarre events doesn’t happen!’).
For a detective investigation the following recommendations can be made:
1. It is not wise to make the ritual itself into a subject of investigation. The first priority are the crimes that are supposed to be committed; whether they happened in the context of a ritual is of secundary importance.

Witnesses and their statements in this kind of cases form a problem. It is not a priori clear which part of their statements is valid and which is not. It is therefore of essential importance to check the statements ‘internally’ and ‘externally’.
2. In the interest of the investigation it is recommended to record all statements of victims and suspects integrally on tape.

The ‘external’ check on statements is the most important.
3. One should try to check all facts told as well as possible.

The internal checks of the statements of the victims aims – if external support is lacking – at the way the story has been established.
4. The therapist involved should be asked to tell in detail about the way and the pace in which the victim has told the story of the ritual abuse.

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One should consider two things. In the first place in therapy the subjective experiences of the client are much more important than the question whether those experiences are veridical. In detection it is the other way around. So it is not easy to investigate on the basis of a story that has been told in therapy.
Therefore it is essential that afterwards is reconstructed as well as possible on what moment which parts of the story have been told first, and in what words.
In the second place therapists have an other reponsibility regards the victims than the police. This is discussed elsewhere in this report. Here it is important that the role of the therapist can resist an extensive and detailed witness report.
It is almost unavoidable that victims among themselves and victims and suspects have contacts with each other. In these contacts the persons involved can influence each other so much that afterwards it cannot be established who is the originator of a story.
5. Contacts between victims and suspects must be mapped out in detail.

Above it has been argued that there are other explanations for the genesis of the stories of the victims. This means that in ritual abuse cases serious efforts should be done to falsify those statements, this means that it must be investigated to which degree the stories may be fictional. (See for verification and falsification extensively: H.F.M. Crombag, P.J. van Koppen en W.A. Wagenaar, 1992, especially chapter 6)

[This is a book, titled Dubieuze zaken, de psychologie van strafrechtelijk bewijs (Dubious affairs, the psychology of criminal evidence). Published by Contact, Amsterdam. This reference to literature is not included in the literature list.]

6. Alternative explanations for the genesis of stories of victims must be examined.

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Finally: in ritual abuse cases there are quite a few elements that do not belong to everyday police practice, like psychiatry of victims, sexual murders and problems of memory and recollection.
7. Expert help from outside may be desirable. The Department of Scientific Detection Advice of the CRI can be helpful.

Prosecution of ritual abuse cases

In Dutch criminal law the judge is – barring some legal restrictions – free to select and evaluate the proposed means of evidence. The restrictions are among others that the proof that the suspect did the deeds he is charged with may not be accepted by the judge if it only rests on the statements by the suspect or the statement of a single witness.
Generally the judge does not have to motivate why he does not consider statements by witnesses or expert witnesses reliable or not and why he does not use certain evidence for the decision.
In general it can be said that proofs in cases of sexual child abuse are not easy. The offenses usually happen in a protected environment and there are usually few people present. If the victims are young children they can have problems to make statements about what happened to them and it can therefore be difficult to get statements that are useful for proof. If the victims are adults, the events have usually happened long ago, which creates problems of proof.
An extra problem in ritual abuse is that victims and witnesses have great resistance (mental blocks) to state what happened; it is assumed that this is because they have been intimidated extremely. Anyway, the witnesses/victims often do have serious psychological disorders, that allegedly are caused by the ritual abuse they experienced.

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An essential part of those disorders are amnesia and different parts of the personality that contradict each other (see APA 1987). Separately from the testimony of the alleged victim there is therefore often need for a statement from an expert witness. From the so-called ”Doll play”-verdict of the Supreme Court of 28 February 1989, [reference NJ 1989, 748] can be deduced that if the defense presents an argued plea that the expert witness’s investigation is not reliable, and that the result of such an investigation may not be used for proof, the judge may not ignore this plea without any argument.

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APPENDIX 2.

DECISION TO INSTITUTE

THE UNDERMINISTER OF JUSTICE,

Taking into account that among others the Inspectorate for Youth Help has signalled cases of ritual abuse and that the question has arisen to which degree these problems occur in The Netherlands, and what possibilities the authorities have in general to react adequately to this, included those of therapy and in that framework inform police and prosecution of cases;

Taking into account that it is therefore desirable that the problem is defined and that a survey is made of those cases that are known to therapy and care organisations and otherwise, and that a survey is made of the problems that can occur when reporting cases to the police and the prosecutor, especially with the intention to possibly further investigate and arrive at procedures for reporting;

Decides

I   to institute a working group
A that has as task
1. to define ritual abuse;
2. to map out the problems by taking stock of cases
known to care and therapy institutions and other
known cases;
3. to examine which problems can be expected when
reports of ritual abuse are filed with the police and
the prosecution;

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4. to formulate if necessary proposals for further
investigation and a reporting procedure;

B that is composed as follows:
– Mr. J.A. Hulsenbek – chief prosecutor of the Arnhem
court, chairman;
– Prof. Dr. H. Baartman – professor Vrije Universiteit
Amsterdam – department of psychology and pedagogy;
– Ms. mr. M. Verweel (replaced by Ms. drs. P.I. Polman)
Department of Social Work, Public Health and Culture,
Directorate of Mental Health, Addiction Problems and
Consumer’s Policy;
– Dr. P.J. van Koppen – Study Center Criminality and
Maintenance of Law;
– Drs. D. Brons – Directorate Youth Protection and
Rehabilitation.
– Drs. D. Roodzant – Directorate Police;
– Mr. A.T.J. de Boer – Directorate Constitutional and
Criminal Law – secretary;

As advisors were added to the working group:

– Drs. R.M.A.Th. Aalders – Chief Inspector Youth Care
– Ms. M.D. Lamping-Goos (neurologist) – Medical Chief
Inspector for Mental Health;

[the last person mentioned has that function in the Directorate of Youth Care and Mental Health. The academic titles are given as they are in Dutch. They mean: ”Mr.” – a law degree ”Drs.” – a Master degree. Medical degrees in Dutch are not indicated by prefix, but by postfix ”arts” or the specialism concerned.]
II A that the working group can hear experts and other
people involved;
B the working group will produce within 6 months
after its institution at least an interim report
and if possible a final report

‘s-Gravenhage, August 12, 1993
The Underminister of Justice

[The report was presented on April 21, 1994]

APPENDIX 3.

Literature

[the following list might seem fairly littered with errors. However, it is a faithful reproduction of the original.]

American Psychiatric Association (1987) Diagnostic and Statistical Manual of mental Disorders; Washington DC: American Psychiatric Association (3d revised ed.).

Boyd, A. (1991) Blasphemous rumours. Is satanic ritual abuse fact or fiction? An investigation. London: HaperCollins.

Brunvand, J.H. (1983) The vanishing hitchhiker: American urban legends and their meaning. Picador.

Brunvand, J.H. (1984) The choking doberman and other ‘new’ urban legends. New York: Norton.

Brunvand, J.H. (1986) The Mexican pet: More ‘new’ urban legends and some old favorites. London: Penguin.

Burger, P. (1992) De wraak van de kangoeroe: Sagen uit het moderne leven. Amsterdam: Prometeus.

Burger, P. (1994) Satanisten als zondebok voor porno en incest. (3 maart) De Volkskrant 9.

Commissie seksueel misbruik van jeugdigen (1994), Handelen bij vermoeden van seksueel misbruik van kinderen en jeugdigen, p.80.

Creighton, S.J. (1992) Child abuse trends in England and Wales, 1988-1990 and an overview from 1973-1990. London: NSPCC.

Creighton, S.J. (1993) Organized abuse: NSPCC experience. Child Abuse Review, 2, 232-242.

Doek, J.E. (1992) Kindermishandeling, beroepsgeheim, privacy en inzage van vertrouwelijke gegevens in: Kindermishandeling resultaten van multidisciplinair onderzoek p.279 e.v., Data Medica.

Finkelhor, D. L.M. Williams & N. Burns (1989) Nursery crimes: Sexual abuse in day care. Newbury Park, CA: Sage.

Frenken, J. (1994) Ritueel seksueel misbruik van kinderen: Verslag van een symposium tijdens de Annual Meeting van de

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International Academy of Sex Research in Pasicific Grove (Californië, Verenigde Staten) van 27 juni tot 1 juli 1993. Maandblad Geestelijke Volksgezondheid (in druk).

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