Nov 10, 2018

Working with Patients from High Control Groups, Part 1

What Therapists Should Know

Ekaterina Musok, LCSW

Psych Central
November 8, 2018

Mental health practitioners need to be aware of the harmful psychological issues current and ex-cult members continue to show even after they leave such an organization. Individuals who have become part of these restrictive religious groups generally suffer from rigid thinking patterns, feelings of guilt, shame, and a sense of abandonment.

Mental illness and substance abuse are also commonly observed. Suicidal tendencies, PTSD, anxiety and depression are just some of the consequences that these patients endure. Psychologists, LCSWs, LMFTs and LMHCs can utilize a variety of approaches when working with this population. Most researchers agree that educating patients on the cult’s history and destructive practices is the building block and lays the foundation of their recovery.

Religious cults, also known as new religious movements (NRM), have had a consistent presence over the past 100 years. Generally, when the word cult is mentioned, people envision scenes of the Jonestown massacre, mass weddings, polygamy marriages or individuals living in segregated communities.

Cult Members Often Cut Off Contact With Loved Ones

But not all destructive cults are so dramatic. The loss of free will, commonly called brainwashing, is generally used to explain why members choose to remain in such high control groups. Destructive cults often require their rank-and-file members to donate the majority, if not all of their time, effort, and money to the group’s purpose.

It is not unheard of for cult members to slowly or abruptly discontinue association with their family and friends.

Cult leaders use a number of deceptive practices in order to convince their audience that the mission and vision of the group is paramount and that everyone not showing adherence to it is an opposer. A member’s previous social circle is viewed as a threat because family and friends could potentially persuade their loved one to stop attending the cult’s activities.

It is therefore not surprising that rank-and-file members are encouraged to minimize their interactions and lines of communication with any non-cult members.

The more time an individual spends with cult members, the more indoctrinated he or she becomes and the stronger the belief that the cult’s leadership has answers to all life’s questions.

By cutting ties with former friends and family, the social support that a member now has is exclusively formed by other cult members. Together, members of high control religious groups consistently reinforce the cult-like mentality amongst one another. Often, cult leadership expects the rank-and-file members to report any “suspicious,” unpermitted activities by other members.

Learning about cults, their methods, tactics and internal practices is of relevance today more than ever. About three years ago, a documentary aired by the Oscar winning producer Alex Gibney made all the headlines both on social media and major TV networks.

Documentary Spikes Awareness

The documentary, “Going Clear: Scientology and the Prison of Belief” shows several interviews with high executive Scientology members who were either “kicked out” or left the group on their own. As interesting as this documentary may be, it’s true value was bringing awareness to the general public that any individual, regardless of history, social status, race and gender, can be a potential victim to such groups and movements.

It is imperative for mental health practitioners to be able to discern the underlying issues and experiences that clients from high control groups have had. Research has shown that active and ex-members suffer from mental illness, substance abuse, and co-morbid disorders.

Among the many psychiatric diagnosis, the most frequent symptom is disassociation, also called “floating” (Coates, 2010). Additionally, PTSD, anxiety, depression, destructive and suicidal tendencies are also commonly diagnosed (Coates, 2010). Many of the individuals who were either “kicked out,” left on their own or have become inactive, have a difficult time opening up and sharing their experiences. Feelings of guilt, shame and abandonment from their formal cult-family remain even after leaving the group.

Intervention Has Clients Evaluate Early Beliefs

The psychological literature is overwhelmingly united in comparing cult members’ experiences to those of concentration camp survivors and former POWs (Coates, 2010).

Because of years of indoctrination and brainwashing, members of high control groups remain psychologically scarred for many years after leaving a cult. Members are explicitly forbidden to watch, read or discuss information critical to the group (Walsh, 2001). Living in a cult enforces members to internalize their problems.

For those associated with Bible-based cults, the line of thinking is that if members are feeling down and depressed, this mood must be undoubtedly because of the fact that they are not spiritual enough. Consequently, members force themselves to outdo other members’ performance in hopes of becoming more spiritual and achieve the promised happiness. Unfortunately, these activities only tend to reinforce the cult-identity and cult-like mentality.

The experience of rigid thinking (black and white terms), the inability to make decisions, issues with relationships as well as feelings of self-blame, guilt and shame all require a specific type of treatment.

Psychotherapists have two roles when dealing with patients who hold harmful religious beliefs: understanding the clients’ problems and identifying effective treatment methods (Rosenfeld, 2010). Additionally, therapists must be confident that their clients have enough motivation and social support to cope with the potential loss they may endure if they were to leave the cult (Rosenfeld, 2010).

A common treatment intervention for psychotherapists to follow is to encourage clients to critically evaluate the beliefs they had acquired during their early childhood. This process is especially true for those born in cults who have never had the chance to examine their religion or have never had access to a different religious belief.

Motivational interviewing is instrumental since a cult member would attempt to explore their beliefs objectively (Miller & Rollnick, 2002). Moreover, neutrally reviewing previously held beliefs with other alternative beliefs allows the member to compare their religion to those of others and see similarities.

For some, leaving a cult is associated with freedom, a new chance in life and the possibility to make personal decisions on their own. Others however, feel overwhelmed, lost and cut off from the life they had built while in the cult.

In many situations, members have had to give up communication with their spouses, children, grandchildren, cousins, nephews, nieces, uncles, aunts and friends. For those who have chosen to leave on their own, the cult leadership shows their leaving as a sign of disloyalty to the “true organization.” Any remaining cult members are required to discontinue all association with them.
More information about Ekaterina Musok, LCSW can be found at

APA Reference 

Musok,, E. (2018). Working with Patients from High Control Groups, Part 1. Psych Central. Retrieved on November 10, 2018, from

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