Texas Jury Awards Largest Amount Ever to Patient in Recovered-Memories Case

The fallout from the controversy surrounding memories of abuse that are recovered during psychotherapy escalated dramatically in August, when a Texas jury awarded $5.8 million - the largest damage amount to date in these high-profile cases - in a lawsuit in which a patient sued her psychiatrist for malpractice. She had charged the therapist with planting false memories of sexual abuse and participation in satanic cult rituals.

The case also highlights the burgeoning trend of patients willing to sue psychiatrists and mental health professionals for engaging in negligent psychotherapy - a trend at the root of the increasing malpractice premiums facing more and more psychiatrists in the last two to three years.

The jurors awarded the huge sum to plaintiff Lynn Carl, who was being treated for depression and multiple personality disorder by psychiatrist Gloria Keraga, M.D., in the now-disbanded dissociative disorders unit of a private psychiatric hospital in Houston. The therapy occurred from 1991 to 1993, a period that saw an explosion of interest among patients and clinicians in therapies whose goal was to awaken long-repressed memories of childhood sexual abuse, many accounts of which were later withdrawn by the patients or proven to be inaccurate.

Carl accused her therapists at Spring Shadows Glen Hospital of implanting memories of her participation over many years in satanic rituals that involved sexual abuse, incest, torture, and cannibalism. She came to believe that she was both the victim and the perpetrator of these acts.

According to the Houston Chronicle, she alleged that the therapists primary motive was to keep her in the hospital long enough to collect the maximum amount of insurance reimbursement - just over $1 million - and they did so even though her condition progressively deteriorated while they were treating her.

Carl's attorney, Skip Simpson, argued as well that a psychiatrist should be guided by a great deal of skepticism whenever he or she is confronted with a patient claiming to have participated in satanic cult activities as bizarre as the ones described by Carl during her therapy, and that Keraga was negligent in proceeding as if they were true. Keraga maintained that she approached these memories from a neutral standpoint and did not automatically base her therapy on the assumption that these reports were accurate.

More than a dozen other former patients with multiple personality disorder at that hospital have filed similar suits contending that they were the victims of psychotherapists who planted false memories in the guise of treating them.

The plaintiff maintained that as a consequence of her believing that the memories of sexual abuse and bizarre cult rituals she "recovered" during psychotherapy were real, her marriage ended and she lost custody of her two children. She has since reconciled with her husband and regained custody of the children. After her therapy at the Houston hospital ended in 1993, she subsequently received psychiatric treatment in Florida and Maryland. It was during these later therapeutic sessions, Carl said, that she realized that the memories of ritual abuse she "recovered" during therapy with Keraga and others at the hospital were false and had been planted.

Keraga, however, insisted that the psychotherapeutic treatment she provided was appropriate in light of the symptoms Carl displayed and the history of abuse she described upon entering the hospital.

On the basis of interviews with several jurors reported by the Chronicle, it appeared that they were strongly swayed by arguments made by Carl's attorney that the psychiatrist failed in her duty to inform her patient that the memories she recovered during hypnosis and other phases of her therapy might not be reliable. It also appeared that the psychiatrist should be held responsible for not stopping these treatments when Carl's symptoms not only failed to improve, but seemed to worsen. Carl charged not only that abuse memories were planted under hypnosis, conducted while she was restrained, but also that she was told by her therapists that unless she continued to recover memories of being abused, she would not be able to regain her mental health and leave the hospital.

The jury appeared to put little store in the case made by Keraga's attorneys that Carl's recovered memories were not false - that she in fact exhibited "overwhelming" evidence of having been the victim of earlier sexual abuse - and that the treatment Keraga provided was appropriate for a patient with such a history. Keraga's attorney, Suzan Cardwell, tried to refute allegations that memories were planted by quoting from journal entries and detailed medical records in which Carl vividly described sexual abuse, murder, and torture, suggesting, according to the Chronicle, that the perpetrators of these cult-related activities could have been Carl's family. The psychiatrist put enough store, however, in Carl's allegations that she sent a letter to an insurance company in 1993, the last year of the therapy at issue, stating that she believed the children were in fact the victims of sexual abuse and torture by a cult.

In explaining why Keraga proceeded as she did with Carl's psychotherapy, her attorney pointed out as well that Carl had a history of psychiatric illness that included severe depression and self-mutilation, syndromes that often are linked to being the victim of childhood sexual abuse. In addition, Carl told child protective authorities that her two children had also been abused by members of this satanic cult. They too were treated at Spring Shadows Glen Hospital after Carl's account of their having been abused, including by her.

"The only thing Dr. Keraga is guilty of is believing in Lynn Carl," insisted attorney Cardwell.

The jury decided, however, that Keraga was responsible for 12 percent of the negligence of which Carl was a victim and then determined that this level of malpractice was worth $5.8 million. More than a dozen other defendants that Carl sued, including several other psychiatric and nonpsychiatric therapists as well as hospital officials, settled out of court, leaving jurors to evaluate only the case against Keraga.