Cult involvement: A systems approach to assessment and treatment

Psychotherapy: Theory, Research, Practice, Training, 0033-3204, 1990, Vol. 27, Issue 1

Cult involvement represents significant challenges to the mental health practitioner. Cults are notoriously difficult to define (Andres & Lane, 1988; Ash, 1984; Sirkin et al., 1984). General agreement exists that a cult is usually characterized by three related tendencies: An authoritarian organization in which the leader has ultimate power; dissimulation about the true nature and beliefs of the group; and the practice of techniques that facilitate and maintain altered states of consciousness.

Psychotherapy for Cult-Related Problems

Unlike most other difficulties for which psychotherapy is sought, the cult-involved individuals usually feel that they have no problems; rather, the family members and others who object to the involvement are in need of assistance. Cult-involvement is ego-syntonic for the individual and family-dystonic for the family system. In order to work effectively with this population, it is essential to simultaneously grasp and respect the cult-involved person’s perspective, and join with and respect the family’s perspective (Minuchin & Fishman, 1981). The goal of treatment is to facilitate family communication and assist the cult member along a normal developmental path appropriate to his or her stage in the life cycle (Carter & McGoldrick, 1980).

Case Illustration

Miriam was brought to the clinic by her parents, who were furious that she had converted from Judaism to Christianity. At one point during the assessment, Miriam stated, "I think my parents are more upset that I believe in God than that I am a Christian." A more careful history revealed that the parents had been active socialists in their youth and members of the Communist party, although the parents’ parents had been religious Jews. Miriam was correct in her assumption; the ensuing discussion about religion in the life of this family was very productive. I would have been less helpful to explore her specific beliefs in detail.

Christianity and Judaism are not cults, but the vignette illustrates two points: first, that parents will often refer to a belief system with which they disagree as cultic; and second, that a clash of values between parents and child rather than the specific belief system per se often underlies family problems arising from cult involvement.

Because the beliefs and behaviors of cult members are often bizarre, the clinician is tempted to ally with the family against the cult group and the cult member. The problem is compounded by the fact that many of these groups do indeed engage in unethical and psychologically noxious, even dangerous, practices (Ash, 1984; Clark et al., 1981).

Therapeutically, it is more conducive to take the stance that everyone has the right to believe in any philosophy they choose, as long as all the facts are available and no deception has occurred. The primary objection to cults has been the lack of full disclosure about the nature of the group, such that involvement based on informed consent is precluded. If the clinician or the family suspect that deception has been involved, factual information should be obtained specific to the cult group in question. This information may be available from ex-members and organizations such as the American Family Foundation and the Cult Awareness Network. 1 The clinician is advised to let these organizations articulate the anti-cult argument, so that the therapist can maintain a more neutral and flexible position. Ultimately, our stance must be pro-client rather than anti-cult, and our goal the encouragement of individual free choice unencumbered by disinformation or psychopathology.

The Question of Psychopathology

The presence of individual psychopathology must also be a concern for the psychotherapist, whether one considers it a central or peripheral issue. Many systems-oriented clinicians eschew diagnostic labels, believing that they de-emphasize the system at the expense of the patient. Other clinicians feel that the cults themselves induce pathology and that labeling the individual prior to complete disengagement from the group is unjustified. On the other hand, there are clinicians who feel that careful diagnosis is essential to good treatment and that a clear diagnostic formulation is the first priority. A compromise position of sorts has emerged. There is increasing use of the diagnosis of Atypical Dissociative Disorder (or Dissociative Disorder Not Otherwise Specified) (cf. Ash, 1985; Halperin, 1983; West & Singer, 1980). While this diagnosis captures the disintegration of identity one often finds in cultists, it is important to remember that more than one Axis I diagnosis or a concurrent Axis II diagnosis may also be present.

Recent research emphasized the importance of cult vulnerability. One study, sponsored by the Jewish Board of Family and Children’s Services Cult Hot-line and Clinic in New York, concluded that three areas of vulnerability increased susceptibility to cult conversion (Sirkin & Grellong, 1988). In this study families who had at least one cult-involved member were compared with families without cult involvement. We found that cult-involved people had a history of psychological difficulties, including a higher incidence of psychotherapy and significantly more indications of life dissatisfaction. The families with cult involvement demonstrated less emotional expressiveness and more implicit criticism, especially toward the cult-involved member. Finally, the cult-involved group seemed predisposed to seek religious solutions to life’s problems, a difference that seemed to reflect a more spiritual orientation. Altogether these differences accounted for more than 40% of the variance between the two groups.

These findings must be kept in perspective. They should not be construed as "blaming the victims" or the victims’ families. Many individuals who become involved may exhibit no pre-existing vulnerability at all. The role of the family and the importance of the family context must be considered and evaluated in conjunction with individual dynamics and the presence of longstanding personality problems for which individual treatment would be quite appropriate.


If only one family member seeks an initial consultation it is useful to expand the system to see as many family members as soon as possible in the assessment. Each family member, as well as each subsystem, offers a unique perspective on the problem and the family. The family system as a whole, as well as each individual, should be assessed when possible. Problems should be understood in a developmental context (Carter & McGoldrick, 1980).

The Genogram and the Family Life Cycle

Development takes place across both the individual life span (Erikson, 1959; Levinson, 1978) and the family life cycle (Carter & McGoldrick, 1980); both are relevant for cult involvement. During adolescence the individual struggles to achieve identity and to overcome identity confusion (Erikson, 1966). Marcia (1966) has further differentiated adolescence into identity achievement, foreclosure, identity diffusion, and moratorium. Identity achievement refers to a successful resolution of the identity crisis, while foreclosure refers to a premature resolution. Moratorium refers to an identity status in crisis but "on hold," for example, time in college, while identity diffusion refers to a pervasive, ongoing uncertainty about one’s identity. Gitelson and Reed (1981) suggest that"… identity diffused and moratorium youth are vulnerable to cult recruitment" (p. 318). From the family systems perspective, when the developmental tasks of adolescence have not been mastered, the young adult is unable to handle true independence and uses the cult group as a "replacement" family.

Levinson (1978), who conceptualized adult development as an alternating series of life structures and transition periods, discusses early adulthood in terms of three stages: The Early Adult transition stage (17-22), Entering the Adult World, and the Age 30 transition. Most of the young people in our study became involved in the cult during the Early Adult transition (Sirkin & Grellong, 1988). If the struggle to achieve a stable identity structure seems to be the most salient aspect of the clinical picture, then the diagnosis of Identity Disorder would be appropriate (American Psychiatric Association, 1987).

The family develops through its own distinctive life cycle (Carter & McGoldrick, 1980; Duvall, 1977). Two stages most relevant to cult involvement include being a family with adolescents and launching young adults. Individuals and families are especially vulnerable during transition periods from one stage to the other (Barnhill & Longo, 1978). Cult involvement often signals difficulties in the launching stage. As Nichols (1984) states:

The preliminary challenge of the unattached young adult is coming to terms with the family of origin. Optimum resolution of the transition from adolescence to adulthood entails separating from the family, achieving emotional maturity, and developing an independent self-identity. Failure to achieve a mature separation may take the form of prolonged dependency and attachment, or emotional cutoff and reactive flight, (pp. 150-151)

Most cult groups encourage radical disengagement from the family, leading to an emotional cutoff that is a pseudo-resolution to the developmental task of adolescence and young adulthood (Bowen, 1978). This type of emotional cutoff may be understood as a reaction formation to strong dependency needs. For example, it is not unusual to hear parents remark, "John was the perfect child; before this cult involvement we never had any trouble at all with him." The child in such a situation exchanges enmeshment with family for enmeshment with the cult group.

The genogram is an invaluable part of the assessment and can serve several purposes (McGoldrick & Gerson, 1985). It is an enjoyable, nonthreatening task that helps the family feel comfortable. It provides a list of the essential individuals in the family system. It can help the clinician develop a multigenerational perspective. And it serves as an ongoing reference throughout the assessment and treatment process. As an illustrative example, found in a typical cult-involved Jewish family, a grandparent or great-grandparent had been highly religious, perhaps a rabbi, while the parents have become assimilated and non-religious. The cult involvement is then a means to reintroduce spirituality into a family for which it was once an important component of their life.

Case Illustration

Sol, a recent graduate from an Ivy League school, had been told to leave home because of his unacceptable beliefs that a local guru was the messiah. His proselytizing was offensive to both parents who were Reform Jews. Neither the parents nor the grandparents were religious. During the development of a genogram, father remembered there was once a prominent rabbi in the family. Sol, who was the "baby," had never been taken very seriously by the family despite his many talents. When his behavior, including his religious studies during college, was re-framed as an attempt to connect the family with its lost heritage, a flicker of mutual respect passed between father and son.

As illustrated, the structural aspects of the genogram may elucidate certain relationships that would not have been otherwise obvious. One may find that in each generation there has been a family scapegoat, and the cult-involved person may be following an unconscious "script" designed to have him or her targeted as a major problem in an otherwise "perfect" family. As Haley (1985) has pointed out, it is not unusual for problematic young people to serve as symbolic "sacrifices" who keep the family fixed at one developmental stage, saving everyone the risk of further development. The child who remains at home, or becomes the focus of parental attention, may prevent parents from re-negotiating a marital contract that had been implicitly based on raising young children (Sager, 1976).

The Individual in the System

The systemic perspective should not preclude careful consideration of individual problems and psychopathology. Spero (1982, 1983) favors a full psychological evaluation that, "… covers a broad continuum of subject behaviors ranging from current intellectual performance, cognitive style, and psychomotor functioning to the potential for adaptive regression and including the quality of object relations" (Spero, 1982, p. 338). Such procedures are most useful when the person responsible is also the therapist, allowing an effective transition from the testing to the therapy situation. Post-treatment testing may also be useful to demonstrate therapeutic progress.

The clinician may be faced with a chicken-or-egg dilemma in attempting to discern whether psychopathology is a function of cult involvement or vice-versa. In the absence of carefully controlled pre-involvement/post-involvement comparisons, this question may never be resolved. A number of authors have noted that the two are frequently associated (Clark et al., 1981; Galanter et al., 1979; Levin & Salter, 1976; Sirkin & Grellong, 1988). Diagnoses on both Axis I and II are more the rule than the exception. The clinician should be prepared for a rapid resolution of symptomatology if cult involvement is curtailed. One useful distinction is to view the Axis I diagnosis, if present, as the proximal cause or result of cult involvement, while the Axis II diagnosis, if present, is a more distal and long-standing characterological problem that may have rendered the individual vulnerable to recruitment in the first place.

The cognitive sequelae of cult involvement are often dramatic, as the involved individual is sometimes unable to function in common routines of daily living (Sirkin, 1984). Affectively, these people tend to be either emotionally labile or relatively flat (Spero, 1982). A caveat is in order for the clinician when assessing the presence of formal thought disorder: Many cult doctrines may seem bizarre to the uninitiated, and what appears at first glance to be a thought disorder or delusion may actually be accepted cult doctrine. One must separate circumscribed, doctrinaire beliefs from more global, clinical difficulties in reality testing. Additionally, the therapist is urged to differentiate mature religious beliefs (cf. Tillich, 1954) from regressive (Saltzman, 1954) or neurotic approaches to religion (Spero, 1976).

In terms of differential diagnosis, the pressures inherent in joining or leaving a cult may precipitate a psychotic break (e.g., Kirsch & Glass, 1977). In such cases, it is therefore important to differentiate between schizophrenic disorders, delusional disorders, and other psychotic disorders. Similarly, what appears to be a bipolar disorder, with either manic or depressed features, may be an adjustment disorder to loss of the cult group or an attempt to stave off feelings of loss through hyperactivity.

Stages of Cult Involvement

Cult involvement proceeds in stages, each of which appears to have unique cognitive and affective characteristics as well as implications for treatment. Determining the stage of cult involvement is an important goal of the assessment process.


This is the stage of initial contact. The individual is aware of discrepancies between religious ideals and practices. The philosophy behind the religion of birth seems empty, while the cultic religion holds promise. The potential recruit may feel lonely or have experienced a recent disappointment (Sirkin & Grellong, 1988). The recruiters seem like "nice" people, outgoing and friendly. At this stage, unambiguous and accurate information about the group, its hidden agenda, and its questionable practices (if they exist) may be all that is necessary to dissuade the potential recruit from proceeding. Primary prevention is possible at this stage, through appropriate education and information.


At this stage, the individual experiences an intellectual attraction to the cultic philosophy. Often the philosophy seems superior to that which is being given up. The potential convert may believe that disparate philosophies, however dissonant, are compatible, e.g., Judaism and Christianity in the case of Jews for Jesus.

At the emotional level, "love-bombing" and total acceptance offer the promise of friendship and meaningful, positive relationships. A childlike naïveté is pervasive and encouraged. Suspension of critical thinking is encouraged and reinforced; one may be attracted to general ideas, such as "unification" or "world hunger" without being inclined toward critical evaluation. The decision to join, to become one of the group, is usually spontaneous and sudden. The individual is reluctant to hear anything negative about the group; it may be extremely difficult to convince him or her that the group has any but the best intentions.


Conway & Siegelman (1978) propose that the decision to join a cult is a sudden, overwhelming experience they term "snapping." While this may be accurate in some cases, a more common scenario involves a gradual intensification of feeling to the point where the group and its activities are of consuming interest to the potential convert. Central elements of one’s identity come under attack leading to a profound questioning of old beliefs (Ofshe & Singer, 1986). Recruits are bombarded with a great deal of new and detailed information, while at the same time their ability to critically process this information is compromised. The executive functions responsible for planning, goal-directedness, and evaluation are severely diminished (Sirkin, 1984).

Associated with these cognitive changes are emotional lability alternating with flat or blunted affect. Parents will panic and insist that "something" must be done. At this point the individual is at greatest risk for psychotic reactions. Unless there is a severe break with reality or some physiological deprivation, this stage should not last more than several weeks at the most. Direct and aggressive challenges to the recruit from family or clinician are not helpful and will only serve to strengthen the growing bond with the cult.

Social Disengagement

Following the intensification stage, critical thinking returns, although cognitive lacunae are usually evident. The individual sets about trying to create a new life; this may involve a distancing from old family members and friends in exchange for new relationships in the cult. Not coincidentally, many cults encourage this process by referring to the leader as "father" or "mother." Family-like ties are nurtured among group members while contact with the "old" family is discouraged. A quasi-paranoid worldview may discourage contact with the "uninitiated" except for recruitment or fund raising purposes (Lifton, 1963; Sirkin, 1988).

Ironically, at this stage clinical engagement is more possible than it has been since joining. Most individuals want their family to simply accept that they have made an important decision and that their lives are better. Framing, or re-framing, the problem correctly is critical at this stage, because at no other is it more true that the family, rather than the patient, has a problem. If family dialogue can be fostered, the entire family may benefit from the crisis.


After months or years in a cult group, basic aspects of identity may be altered. An individual may have taken a new name, married, had children, and made other attempts to resume a normal life within the cult. Life goes on, but with all the difficulties of living an alternative life-style. The individual has become aware that the cult group is flawed, that the ideals do not match the realities, but will nevertheless insist on the positive aspects of the cult and perhaps also continue to idealize or worship its leader.

Individuals at this stage may feel pain at having cut-off the family of origin and may seek to re-contact, often with much ambivalence. Ironically, family members may have such negative feelings about the cult that it is difficult for them to tolerate these tentative overtures. Parents may insist that the individual makes a clean break from the group and be unwilling to acknowledge any positive aspects of involvement. The parents may have become "stuck" in mourning or bitterness over their perceived loss. Families at this stage can be assisted in the restoration of normal relations. Whether the cult-involved family members continue or discontinue the affiliation, all family members need to proceed along their respective developmental paths.


The importance of assessment brings to mind a quotation attributed to Abraham Lincoln, "If I have eight hours to chop wood, I’d spend six hours sharpening my axe." A careful assessment is like sharpening one’s axe. Once the family and its members are understood, therapy can proceed along fairly standard lines.

The therapist may act initially as a systems consultant, assisting the family to understand what has happened and how to deal effectively with the problem (Singer, 1986; Wynne et al., 1986).

Family therapy or individual psychotherapy with one or more family members are among the possible interventions. Voluntary exit counseling with the cult-involved individual may be another recommendation. Exit counseling consists of intensive discussions about the cult group and the psychology of cult involvement with a knowledgeable professional or team (Ross & Langone, 1988). This process can take several hours or days. In-depth psychotherapy is helpful, if not essential, following such a procedure. Work with the family as a whole might precede, follow, or coincide with the individual work. Professionals not trained in all aspects of this process (few are) should make appropriate referrals and serve as coordinator of the professional team.

Family Treatment

Although a growing number of researchers have addressed familial issues in cult involvement (Schwartz & Kaslow, 1979; Sirkin & Grellong, 1988; Wright & Piper, 1986), Markowitz (1985) and Schwartz (1983) are among the few to offer guidelines from a family systems perspective. Markowitz (1985) has characterized the families of cultists as rigid and enmeshed, with unrealistic expectations and goals. Thus, "the transition to adult life for young family members becomes a most threatening developmental crisis for the entire family" (Markowitz, 1985, p. 289). He further observes that conflict between the cult-involved child and the opposite-sex parent is a common family dynamic.

Markowitz (1985) outlines his work with families in terms of three phases, corresponding to pre-extrication, extrication-in-process, and post-extrication from the cult. During pre-extrication, the therapist assists the family to improve communications with the cult member, by providing information about the involvement process, and helps the family feel competent to deal with the problem. Opening lines of communication within the family is the goal of this phase, as the clinician probes for strengths and pathology among the family members. In the second phase, the cult member and the family are seen together to discuss differences and disappointments as well as to establish a basis for future discussion. Heated exchanges about cultic philosophy should be blocked. Every effort should be made to de-triangulate the cult member by encouraging a parental alliance. It is easier to move toward independence from parents who are mutually supportive. The third phase involves assisting the family in normalizing relations after the individual has left the group. The family is at risk at this point because following extrication there may be a regressive tendency to resume old patterns of functioning. This must be challenged by the therapist who can actively aid families to move on to a more appropriate stage in the family life cycle.

Individual Therapy

Family system does not preclude individual and group therapy (Goldberg & Goldberg, 1982). Both are important and they may proceed independently. Depending on the person’s stage of cult involvement, the clinician may be faced with a disappointed, confused, or angry patient. When departure from the cult is sudden and complete, Goldberg and Goldberg (1982) have identified three discrete phases through which most individuals seem to pass. Phase One, Initial Deprogramming lasts from about six to eight weeks, and includes dissociative phenomena, self-doubt, and confusion. The Goldbergs feel that without deprogramming, phase one phenomena will be present but last longer. During Phase Two, Reemergence, the pre-cult personality begins to return. With a growing self-confidence comes anger at the cult group, although rarely at the leader directly, and sometimes involvement in anti-cult activities. Support of other ex-cult members is often experienced as extremely helpful at this stage which may last for two years following cult departure. Phase Three, Integration allows the individual to come to terms with the cult experience. A psychotherapist, and possibly a support group, may assist in the exploration of predisposing factors which may have led to involvement.

It is at this point in the treatment when the traditional techniques of insight-oriented psychotherapy are most helpful (cf. Spero, 1982). Often cults reinforce personality patterns that are not adaptive outside the group. Passive dependent characteristics may have been adaptive while in the cult. Paranoid tendencies are reinforced when one belongs to a group that has the "secret to the universe" and implicitly promises the individual a significant role in world history. The complete authority that middle- and upper-level members have over those beneath them in the cult hierarchy may appeal to the narcissistic personality. Whether the clinician finds evidence of a premorbid personality disorder, or can identify only tendencies, these are the personality characteristics that have made this particular individual vulnerable to a particular cult. These same characteristics are those addressed in psychotherapy.

Case Illustration

Mr. Jones came to discuss his concern about his daughter’s continuing involvement in a Hindu religious order. She had been involved with them peripherally in college and they thought this would end once she graduated and moved back home, but it hadn’t. At my request Mrs. Jones accompanied Mr. Jones and for the next two meetings, a family assessment was done with particular attention to their daughter, Julie. Next, Julie was invited to talk with me and her parents but she stated that she would rather see me alone. We talked about her involvement in the group and other concerns she and her parents had. She accepted my invitation for a trial period of psychotherapy to explore her involvement with the group, and, more importantly from her perspective, what she should do now that she had graduated from college. For the next three months we met weekly to discuss these issues. She agreed to meet with an ex-member of the group to find out things that she didn’t know about this group. The meetings with the ex-member, although few, were important because here was someone who had also been tempted by the group’s promises but chose a more secular path. Slowly, Julie decided to discontinue her involvement with the group and our sessions began to focus on other issues important to her. At the end of 12 weeks, she decided to enroll in a professional school and discontinued treatment.

Many cult members receive psychotherapy, either of the family or individual variety, yet choose to remain in the cult group. One may say to cultists that if they choose to remain in the group after treatment, they will be better members for the experience. Paradoxically, in avoiding an overt struggle with parents, the individual can more freely question the cult involvement from all perspectives.


Authoritarian cults may inhibit healthy development because they offer the illusion of assisting an individual in the process of separation/individuation while in many cases fostering another dependency. The consulting clinician should undertake an assessment that includes evaluation of both the individual cult member and the family system, with specific attention to family and individual life cycle stages and transitions. Although cult-involved individuals and their families are different in some respects from noncult-involved families (Sirkin & Grellong, 1988), these findings should not suggest that the differences cause cult involvement. Rather, in these families, normal developmental transitions may be especially difficult.

Treatment should ideally consist of two components: Family therapy and individual therapy. Exit counseling to help extricate the individual from the group may be indicated. The goal of the family therapy is to open lines of communication and move to the next stage in the family life cycle. The goal of the individual treatment is to enable a person to set and attain individual goals, different from the demands of a group, whether that group be a family or a religious community. Maladaptive personality styles should be identified and new patterns of behavior encouraged. Ultimately, the beliefs are less important than the ability of the individual to choose freely personal goals and relationships.


Cult Awareness Network, 2421 West Pratt Blvd., Ste. 1173, Chicago, IL 60645; American Family Foundation, Box 336, Weston, MA 02193.


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Acknowledgement: I gratefully acknowledge the thoughtful comments on earlier drafts made by Bruce Grellong, Michael Langone, Arnold Markowitz, Joseph Maxey, Maureen Ryan, and Lyman Wynne.

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