Collected Hess Trial Headlines
September 3, 1999
- Fernandez negligent
Jury awards $862,000; both sides view verdict as loss
By Peter J. Wasson
Wausau Daily Herald
Thursday's $862,000 malpractice verdict against Wausau psychiatrist Juan Fernandez III was a partial defeat both for Fernandez and his accusers.
Fernandez hoped the jury would exonerate him of any wrongdoing in his recovered memory therapy and multiple personality diagnosis of Joan Hess.
The Hess family and their attorneys certainly were expecting millions of dollars. Their expert witness fees alone approached $250,000 and they received only a fraction of the $1.2 million they wanted for Joan Hess' past and future medical expenses and lost wages.
In the final analysis, the verdict leaves many questions unanswered about Fernandez, his therapy, his medical license and the ongoing multiple personality disorder debate.
"Certainly I'm delighted with the decisions of the jury," Hess attorney William Smoler said. "I am disappointed in the amount. But this is another in a string of cases that establish that this kind of therapy is simply wrong."
Hess, 44, sued Fernandez, claiming he was negligent in his 1991-1994 treatment of her mental illness. Hess was referred to Fernandez by her former therapist, Carolyn Decker, whom Hess was seeing for depression and other problems.
Hess and her attorneys asserted that Fernandez was a therapist "with an agenda" who looked at Hess and saw more than a depression patient. He embarked on recovered memory therapy using hypnosis shortly after assuming her treatment.
Within months, Hess developed graphic memories of her father and other family members raping her, forcing her to witness baby murders and participate in cannibalism as part of a cult in Ladysmith.
As a result, Hess said, Fernandez convinced her she had multiple personality disorder - a mental illness in which Hess developed dozens of personalities, some of which convinced her to attempt suicide.
Though $862,000 is coming out of the pockets of Fernandez and his insurance company, the verdict cost him much more than that. He listened to days of expert testimony from top psychiatrists in the country questioning his judgment and technique.
Neither he nor his attorneys would comment on how those opinions and publicity about the case might affect Fernandez's practice.
Jurors leaving the Marathon County Courthouse Thursday afternoon after three days of deliberations declined to comment on their verdict, so it is not known how they concluded Fernandez was negligent.
Smoler and co-counsel Pam Schmelzer declined to speculate on how jurors either made their decision or arrived at the dollar amounts they awarded. They were convinced, however, that their message got through to jurors.
"I hope this kind of thing stops," Smoler said. "I hope recovered memory therapy is done. It's bad stuff."
Fernandez also refused to comment on the verdict and quickly left the courthouse after the verdict, leaving attorney Tom Rusboldt to face reporters.
"It's kind of disappointing," said Rusboldt, who added that he will examine trial transcripts before making a decision about appeal. "It's less than $1 million, and they wanted $1.2 million just in medical damages, so that is a small victory."
Rusboldt also expressed appreciation for the witnesses who testified on Fernandez's behalf and Fernandez's patients, many of whom attended the trial and apparently still believe in their doctor.
"Some of the most outstanding experts in the country came here and supported Dr. Fernandez in this case," he said. That says a lot. That means a lot to Dr. Fernandez."
Though Smoler hopes the $862,000 verdict will cause Fernandez and other multiple personality disorder therapists in Wisconsin to reconsider the damage they might be doing to patients, he does not know the long-term effect the award might have.
Already, he said, some insurance carriers are asking psychiatrists if they do recovered-memory therapy and use hypnosis, and are refusing to insure those who do.
"I know the newspaper stories about this case are being read all over the country and I sincerely hope therapists are listening," he said. "This is simply bad therapy. It ruins people's lives."
More important than the effect on doctors is the effect of the verdict on Joan Hess and her family, Smoler said.
It allows Hess to finally conclude that she is not to blame for the memories she developed and now disbelieves. It allows her some measure of relief from the shame she feels for disowning her father, neglecting her family and alienating her husband, John Hess, during the years of her treatment, Smoler said.
"This is some closure for her," he said. "It lets her know she wasn't just crazy. The truth is, you hate to have your life examined like this."
The money will allow Joan Hess "to put her life back on track," Smoler said. Since the early 1990s, she has been largely unable to work and has had to restrict her sessions with current psychologist Ron Potter-Efron, he said.
Smoler said he has been in contact with some of Fernandez's other multiple personality disorder patients, but declined to comment on whether they are contemplating lawsuits against Fernandez.
He also said he will attempt to recover more money from Fernandez -- presumably witness and attorney fees that exceed $250,000 and could approach twice that figure -- through post-trial motions.
- Fernandez testimony key to verdict
By Peter J. Wasson
Wausau Daily Herald
Jurors were swamped with information over the 26 days of testimony and argument in the Hess-Fernandez malpractice trial.
A dozen experts in psychiatry, multiple personality disorder, hypnosis and epidemics testified, as did Joan Hess, her friends and others who helped treat her.
The sheer volume of information no doubt led to the three days of deliberations required to reach a verdict, though only one of 15 jurors dissented with the final decision.
The following were seen as key moments in the trial that could have influenced jurors in their decision:
- Fernandez's avoidance of questions as to whether he really believed Joan Hess, her father, mother and even a relative who is a nun were members of a multigenerational, baby-killing, flesh-eating satanic cult that practiced bestiality.
When asked repeatedly if he should have questioned Hess' outrageous memories or tried to verify them through childhood medical records or recollections of other family members, Fernandez would only say it was his responsibility to remain neutral.
It gradually became clear that none of those things had ever happened to Hess. Hess was a virgin when she married former Wausau mayor John Hess, disproving memories that she was raped by cult members.
His refusal to say the memories were clearly inaccurate no doubt cost Fernandez credibility in the minds of jurors.
- Likewise, Fernandez's hypnosis library helped discredit him. Fernandez testified he had only informal hypnosis training during his psychiatric residency, but explained to jurors that he had in his office a complete library on hypnotic technique and practice.
Fernandez said he read all the books and referred to them extensively while treating patients, whenever he had a question about hypnosis.
Hess attorney William Smoler then subpoenaed the books and forced Fernandez to bring them to court the next day. He then handed them around to jurors and encouraged them to thumb through them.
As jurors opened the books that Fernandez said he read and often referred to, the cracks and creaks of book spines echoed through the courtroom. The books were, to all appearances, practically new and unread.
Fernandez explained the moment by saying he took very good care of his books.
- Hess' current therapist, Ron Potter-Efron, did as much as any of the experts to discredit Fernandez. Fernandez said he believed his therapy, using hypnosis and hidden memory retrieval, was the only way to cure Hess' multiple personality disorder.
To get better, Fernandez told Hess, she had to "empty out all the garbage cans" in her memory. Only when the cans were empty, he said, would she improve, and before she got better, she would get worse.
When Hess went to Potter-Efron in 1994, she told him she wanted more memory retrieval because Fernandez had convinced her it was the correct course. Potter-Efron refused to use it or hypnosis.
Within a few months of starting with Potter-Efron, Hess' memories and alter personalities disappeared, he said. It was convincing evidence that Fernandez's therapy caused the memories instead of treating them.
- County will pick up part of trial cost
Wausau Daily Herald
Marathon County taxpayers will foot the bill for some of the expenses in the six-week Hess vs. Fernandez trial but county officials have not yet tabulated costs.
"We will assemble a list of total case costs when all is said and done," said Donna Seidel, clerk of courts. "That will probably be finished early next week."
One cost easily calculated is the daily per diem for the 15 jurors. Each receives $22 a day, which means the county will pay a total of $9,570 from July 26 through Thursday.
Jurors also receive 29 cents a mile for travel between the courthouse and their homes.
In addition, the county will pay wages and benefits for the court clerk who sat through almost 230 hours of testimony, and for the bailiffs.
Even more significant are the costs that county taxpayers will not have to worry about, Seidel said.
Each side in the case will have to pay for its own expert witnesses, which cost thousands of dollars for travel, research time and other expenses. Meanwhile, the county has used its own courtrooms and a temporary room for the trial to avoid paying rent.
"We were quoted figures up to $30,000 a month" for renting private property, Seidel said.
The state pays Judge Thomas Williams' salary and other expenses because he is a state employee.
The Hess-Fernandez trial will be treated like any other civil case in the Marathon County court system, Seidel said.
"There frequently are jury cases in civil matters that are paid for by county taxpayers," she said. "What is unusual about this is the high visibility and the length of the case."September 2, 1999
- No verdict for a second day in Hess trial
Jurors request excerpts from Fernandez's textbook
By Peter J. Wasson
Wausau Daily Herald
Jurors again gave up Wednesday following 16 hours of deliberations without reaching a verdict in the Hess-Fernandez malpractice suit.
As they did Tuesday, during their first day of deliberations, jurors again sent Judge Thomas Williams several notes Wednesday asking questions.
The two most significant could be seen as an indication jurors are leaning in favor of Hess as they try to determine if psychiatrist Juan Fernandez III was negligent in his treatment of Joan Hess.
During the five-week trial, jurors learned Fernandez was Hess' therapist for four years starting in 1991 when she was referred to him for depression, work-related stress and relationship problems with her husband, former Wausau mayor John Hess.
Hess claims in her suit that Fernandez used hypnosis on her without proper training and, in doing so, convinced her that she was molested as a child by a satanic cult in Ladysmith.
As a result of those memories, Hess developed dozens of personalities, many of which convinced her to attempt suicide, Hess claims, and Fernandez diagnosed her with multiple personality disorder, or MPD.
Fernandez defended himself during the trial by saying he used only appropriate hypnotic techniques on Hess and that all of his treatment was recognized as standard care at the time.
During their first day of deliberations, jurors asked for and received copies of pages from the psychiatry textbook Fernandez studied during his residency training and later consulted in his practice.
The request seemed to indicate jurors were looking favorably upon Fernandez's contention that hypnosis, memory-retrieval and therapy were the recommended treatment for MPD.
Wednesday's jury questions, however, could be seen as just the opposite:
- Jurors first asked if they had to find Fernandez completely negligent or just partially negligent in his care. Williams told them any negligence constitutes negligence.
Obviously, the Hess team would be encouraged by the idea that jurors were trying to determine how negligent Fernandez had to be in order to be found responsible for Hess' injuries.
- Jurors also asked, but did not receive, the chapters on depression from Fernandez's textbook. Williams ruled that the chapter was referred to during the trial but never entered into evidence, so the jury could not see it.
Nevertheless, Hess' attorneys could take that as encouragement because they argued that Fernandez started using hypnosis and memory retrieval when Hess only had been diagnosed with depression.
Even if Fernandez's treatment was appropriate for MPD, there was nothing to suggest hypnosis and memory retrieval should be used in depression, they said.
September 1, 1999
- Fernandez jury closes first day
By Peter J. Wasson
Wausau Daily Herald
Jurors in the Hess vs. Fernandez negligence trial ended deliberations Tuesday by asking Judge Thomas Williams a question: Can we go home for the night?
Williams granted the request, allowing the jury to retire at 4 p.m. after eight hours locked alone in their room during their first full day of deliberations.
Williams said he is allowing the jury to make its own schedule and quit when they want because their job is difficult and they have been away from their families for most of five weeks.
Members of the jury heard 26 days of testimony and argument on behalf of Joan Hess, her family and their former therapist, Wausau psychiatrist Juan Fernandez III.
The Hess family is suing Fernandez, claiming he used hypnosis to implant in Joan Hess' mind brutal memories of being sexually abused as a child by her father and other members of a cult.
Fernandez also convinced Hess she had developed dozens of personalities in reaction to those memories, Hess claims, and that some of her alter personalities convinced her to attempt suicide on several occasions.
Fernandez has defended himself by saying his multiple personality disorder diagnosis of Hess was correct and that he did nothing improper by using hypnosis to treat her.
Both sides presented jurors with psychiatric and hypnosis experts, and between them admitted more than 1,000 exhibits comprising tens of thousands of pages into the record.
Jurors Tuesday asked for copies of several of those exhibits, the most significant of which were pages from a psychiatry textbook that Fernandez said he studied during his residency training and used in his office.
The request for the textbook pages could be seen as promising for Fernandez because his attorneys used the book to show that Fernandez was using accepted and proven methods of treatment on Hess.
Hess attorney William Smoler tried on several occasions during the trial to have the book excluded from evidence because, among other reasons, the individual authors of the books chapters were not known.
He raised that argument again Tuesday when the jury asked for the pages and again lost his battle.
He succeeded, however, in convincing Williams that jurors also should see footnotes and other segments of the book that indicate the text's authors relied heavily upon research done by a small group of multiple personality disorder advocates that Smoler has labeled a "cottage industry" supporting itself by diagnosing and treating the disorder.
The MPD diagnosis was at the heart of much of the trial's testimony because the psychiatric community is so divided over its validity and the treatment of the illness. In recent years, several therapists have been sued successfully for improperly treating MPD patients.
August 31, 1999
- Hess case goes to jury
Debate focuses on multiple personality issue
By Peter J. Wasson
Wausau Daily Herald
Jurors in the Hess vs. Fernandez trial today began to debate issues that decades of scientific thought and research have not been able to settle.
Is multiple personality disorder a genuine illness, or is it caused by bad therapy? Can hypnosis help bring out hidden childhood memories, or does it cause them?
Attorneys for Wausau resident Joan Hess and psychiatrist Juan Fernandez III agreed on little during their closing arguments Monday, but both sides said the personality disorder-recovered memory debate will rage on in the scientific community and other courtrooms.
The four lawyers Monday boiled five weeks of testimony down to five hours of closings before handing the case to the jury. With more than 1,000 exhibits composed of tens of thousands of pages, jurors have much to sort through.
Hess is suing Fernandez, her psychiatrist from 1991 to 1994, claiming he used hypnosis to implant in her mind memories of childhood abuse. The abuse, Hess said, included her father and other family members who were members of a cult sexually assaulting her and forcing her to watch babies being killed and eaten.
As a result of her belief in those memories, Hess claims, she developed multiple personality disorder, or MPD. Hess, who was married to former Wausau Mayor John Hess at the time, said she displayed dozens of personalities, some of which persuaded her to attempt suicide.
A dozen medical and psychiatric witnesses testified during the trial, evenly divided over whether MPD and repressed memories are valid diagnoses or whether MPD is caused exclusively by negligent therapists. Some were certain one way or another and some had mixed opinions.
With so much testimony to summarize, lawyers for both sides said they could only hit high points Monday.
How it started
Hess came to Fernandez after being referred to him by her therapist, Carolyn Decker, who was treating her for depression, family troubles, work stress and other ailments. Until she met Fernandez, Hess was taking depression medication prescribed to her by her family physician.
The medication was ineffective and Decker, now Carolyn Muir, suggested Hess go to Fernandez because he was better trained in such medication as a psychiatrist. Fernandez recently had moved to Wausau to take a job as a child psychiatrist with North Central Health Care Center.
During her treatment with Decker, Hess said there were portions of her childhood she couldnt recall. She said she felt there was something bad in her past, and Decker started hypnotizing her to help her focus on her past.
That much, both sides agree upon. What happened next is at the heart of the dispute.
In early 1991, during hypnosis with Decker, Hess reported her first recollections of being fondled as a child by her father. Hess attorneys said Decker was untrained and ill-prepared to perform memory-retrieval hypnosis, and both sides have said that Decker might have played a part in the development of Hess memories.
In any event, Hess depression worsened and, in May 1991, she was hospitalized as suicidal for almost a month. During that month, Decker continued to hypnotize Hess and Fernandez saw her for an hour almost every day.
The Hess case
Hess attorneys, William Smoler and Pam Schmelzer, said Fernandezs responsibility began at that point. As the psychiatrist who admitted Hess to Wausau Hospitals psychiatric ward, he had final say in her treatment, Smoler said.
As the captain of the ship in her case, he had a responsibility to stop any questionable therapy, monitor the patients Hess came in contact with and prevent her from reading suggestive books.
After Hess was released from the hospital, she had ups and downs but, overall, gradually worsened. Smoler said Hess was seeing Decker regularly during that time, but Decker denied it during her testimony. Both sides agreed it will never be known if the two really continued therapy.
By late 1991, Hess recollections of her father fondling her had grown to include vivid flashbacks of him brutally sexually abusing her. During that time, Fernandez continued to see her periodically.
By summer of 1992, Hess had been hospitalized several more times and Fernandez diagnosed her as having MPD. As months wore on, she reported memories of satanic abuse at the hands of a cult, bestiality and cannibalism.
Smoler said the validity of Hess MPD diagnosis, or whether hypnotically retrieved memories are accurate, has consumed much of the trial but isnt really the point.
Whether the memories are real or false, Smoler said, Fernandez still failed to do what any good psychiatrist should do: He never did a complete assessment and diagnosis of Hess and never tried to determine if her memories were factual.
Fernandez forged ahead with his MPD treatment without making sure that was her real illness or where it came from, Smoler said, and ignored evidence that hypnosis and memory retrieval themselves can cause MPD.
By doing so, Smoler said, Fernandez fell below the legal standard of care, which is what any reasonable doctor would have done in his place given the same circumstances.
Fernandez never received informed consent from Hess to continue with his treatment, Schmelzer said. According to Wisconsin law, doctors have a duty to tell patients their treatment options and the risks involved with any course of treatment.
Fernandez never told Hess that hypnosis was risky, or that he had little training in hypnosis, or that she could have chosen several other successful therapy options rather than hypnosis and memory retrieval, Hess attorneys said.
The Fernandez defense
Fernandezs attorneys, Tom Rusboldt and Paul Grimstad, agreed that the validity of MPD is not an issue, despite all the testimony for and against it.
Fernandez adhered to the standard of care because he pursued the only MPD treatment known to psychiatrists at the time, they said.
Grimstad referred back to Fernandezs residency textbook, one of the most widely used in the country, which said hypnotherapy was the preferred treatment for MPD in 1991.
Thats exactly what Dr. Fernandez did, Grimstad said. Isnt that what doctors should do? Shouldnt doctors follow what theyve been taught?
It is wrong to hold Fernandez responsible for any of Deckers treatment, Grimstad said, because Decker did nothing wrong and he was not her boss in any way during the time she was treating Hess.
Because hypnotherapy was the only recommended, successful method of treating MPD in the early 1990s, Grimstad said, informed consent is not an issue.
There was no other treatment to discuss with her because none was recognized, he said.
Fernandezs lack of training in hypnosis is another nonissue, Grimstad said. The way he used hypnosis is the only issue, he said, and he used it properly.
Attorneys for both sides said jurors had been overwhelmed by scientific evidence and opinion and will find it as impossible as experts have to settle the multiple-personality debate.
There arent any answers to these questions, Grimstad said. The scientists havent solved the problem yet.
August 28, 1999
- Witness: Fernandez within standard of care
By Peter J. Wasson
Wausau Daily Herald
Juan Fernandez IIIs final defense witness Friday was another psychiatrist who agreed that Fernandez did nothing wrong in treating Joan Hess.
Dr. James Chu, clinical director of trauma/disociative disorder treatment program at McLean Hospital in Belmont, Mass., said he has seen hundreds of multiple personality disorder, or MPD, cases over the last 20 years.
He said he agreed that Hess worsened at times during her treatment with Fernandez from 1991 to 1994, but that many MPD patients get worse before getting better.
Even if some of Fernandezs treatment methods would be considered inappropriate today, Chu said, Fernandez was only doing what other MPD therapists were doing in the early 1990s.
Hess is suing Fernandez for allegedly using hypnosis to plant in her mind memories of her father and other family members sexually assaulting her as part of a satanic cult.
Hess further claims that Fernandez convinced her she had developed dozens of personalities in reaction to the memories, and that some of the personalities caused her to attempt suicide.
Fernandezs I was just going along with the crowd defense is valid in malpractice suits that revolve around the legal issue called standard of care.
To be found negligent, jurors must decide if Fernandezs treatment was below the standard of care in the early 1990s. His attorneys are trying to prove Fernandez was within the standard.
In short, the standard of care is what any other reasonable psychiatrist would have done in Fernandezs shoes when faced with a similar set of circumstances.
The standard of care evolves, and it is not the same today as it was a decade ago.
Chu started Friday by giving jurors a brief history of MPD. He said the disorder has been around since the 1800s, but fell into disfavor after Sigmund Freuds introduction of psychoanalysis in the early 1900s.
Chu said he believes MPD cases existed but were misdiagnosed in ensuing decades and werent again regularly diagnosed until the film Sybil was released in 1976.
After that movie granted MPD sufferers permission to discuss their illness, he said, there was really an explosion of reports of MPD cases.
In the early 1990s, Chu said, much of MPD treatment was based upon a 1989 book by Dr. Frank Putnum, Diagnosis and Treatment of Multiple Personality Disorder. The book was the first comprehensive study of the disease, Chu said, and was the foundation of most therapy through 1994.
According to Putnum, a therapist treating an MPD patient should proceed through eight different steps, and Chu said Fernandez followed all of those steps. Furthermore, Chu said, Fernandezs use of hypnosis to speak to Hess different personalities was helpful to her, not harmful as Hesss experts have claimed, because it helped get suicidal alters under control.
As evidence that Fernandez couldnt possibly have created Hesss MPD, Chu referred to some of Hess writings in early 1991, before she became Fernandezs patient, in which Chu believed she showed early signs of having alter personalities.
Hess attorney William Smoler spent much of his cross-examination of Chu trying to show jurors that Chu is yet another member of a small group of psychiatrists who believe in and treat MPD.
Smoler includes Chu in what he has called a cottage industry developed by six or eight doctors who are interested in cultivating MPD and rely upon it for a living. Those six or eight doctors have all either testified or been relied upon by Fernandezs defense, Smoler said, and all have had their MPD units closed or had other legal and ethical problems.
Under cross-examination, Chu conceded that he never has testified against an MPD therapist being sued for negligence and that he really has been primary caregiver for only five or six MPD patients himself.
Smoler was attempting to show that Fernandezs treatment was within the standard of care of Chu and that handful of other MPD doctors, but that the standard of care embraced by the psychiatric community as a whole is much different.
Closing statements in the five-week case are expected to begin Monday.
August 27, 1999
- Fernandez says he never tried to recover memories in testimony
By Peter J. Wasson
Wausau Daily Herald
Juan Fernandez III again said Thursday he never used hypnosis to help Joan Hess recover memories of abuse, despite testimony from even his own witnesses that he did.
Joan Hess' attorney, William Smoler, resumed questioning Fernandez Thursday after Fernandez's cross-examination was earlier postponed for scheduling reasons. Smoler spent much of the day trying to show jurors Fernandez contradicting himself..
Fernandez said two weeks ago he never used hypnosis to retrieve from Hess' mind memories of satanic and other sexual abuse she believed she suffered as a child.
But Smoler Thursday pointed to several references in Fernandez's own case notes in which the psychiatrist used hypnotic trances to "reconstruct," "retrieve" or "uncover" past memories.
Despite those notes, Fernandez maintained he did not use hypnosis that way.
"I'm not going for memories, Mr. Smoler," he said, and added that, "In therapy, we discussed memories."
Hess's memories, and how she came to have them, are at the heart of the five-week negligence and malpractice trial as it draws to a close.
Fernandez also convinced Hess that she had developed dozens of personalities to shield herself from memories of her father raping her and other family members participating in a cult, Hess said.
Fernandez has maintained since the trial began that he did nothing improper in his treatment of Hess from 1991 to 1994 and said again Thursday that he in no way contributed to her mental illness.
Under Smoler's cross-examination, Fernandez contradicted some of his earlier testimony concerning the fact that many professionals believe multiple personality disorder, also known as MPD, is almost always caused by irresponsible therapists.
Fernandez reiterated that, as late as 1996, he was unaware of any controversy surrounding MPD, the diagnosis he assigned Hess. But he then said he learned in 1993 that there were some professionals who believed MPD could be caused by therapists' suggestions to patients.
Finally, he said he considered during her treatment the possibility that Hess' memories were the results of his or therapist Carolyn Decker's suggestions, but he rejected the possibility and never presented it to Hess.
Although he conceded that he had authority over Decker during Hess' May 1991 hospitalization, Fernandez said he never questioned her treatment of Hess and still does not believe Decker contributed to Hess' problems.
Decker, who was originally named as a defendant in the suit, was dismissed after paying the Hess family a $15,000 settlement while denying that she caused Hess any harm. Her attorney said she entered the settlement for "economic reasons" and not as acknowledgment of responsibility.
Perhaps the most damaging piece of Smoler's cross-examination Thursday came after Fernandez again stressed his belief that Hess was improving toward the end of her treatment.
Smoler then pointed to Hess' hospitalization in April 1994, two months before she stopped seeing Fernandez. At that time, Fernandez noted in his records, Hess said she was closer then ever to committing suicide.
August 26, 1999
- Defense witness refutes earlier Hess testimony
By Peter J. Wasson
Wausau Daily Herald
Jurors have heard for weeks about Carolyn Decker Muir, the therapist who was treating Joan Hess when Hess first had memories of childhood sexual abuse.
Throughout the first four weeks of trial, there were continuous references to Decker and her unconventional therapy, involving crystals, pyramids and visits to psychics.
Wednesday jurors got to hear from Decker, but her statements refuted large portions of earlier testimony and appeared to help neither Hess nor Juan Fernandez III.
Hess is suing Fernandez after accusing him of using hypnosis to implant memories of childhood sexual assault, including satanic abuse by members of a cult who practiced murder, rape and bestiality.
Fernandez convinced her, Hess said, that she developed dozens of personalities from 1991 to 1994 in response to those false memories and that her relationships with her family were destroyed.
Hess originally went to Decker in 1990 complaining of mild depression, anxiety, and stress over her job and relationship with husband John Hess. John Hess later went on to become Wausau mayor.
There is no doubt Decker was the first therapist to use hypnosis with Hess in an attempt to help her recall blocks of time in her childhood Hess said she couldnt remember.
Decker said Wednesday she used hypnosis to help Hess relax and focus because she believed Hesss self esteem problems were rooted in something in her childhood. At the same time, Hesss family doctor prescribed depression medication.
In February 1991, Hess complained of complications from her medication and Decker sent her to Fernandez, a psychiatrist, to help her adjust or change drugs. The following several months are the critical time period in the trial.
In May 1991, Fernandez and Decker hospitalized Hess for her suicidal thoughts and both of them visited her in Community Health Care Wausau Hospitals psychiatric unit. It was during that stay Hess first reported memories of her father molesting her.
Fernandez has said he was only responsible for Hess medication, not her therapy, in early 1991. Hess witnesses have said Fernandez, as the senior medical official involved in Hess treatment, was responsible for all her care.
Decker said Wednesday both are true. She was primarily responsible for Hess therapy and hypnosis, she said, while Fernandez was mainly concerned with medication in May 1991.
But she acknowledged Fernandez had the final say in all of Hess treatment and couldnt explain Fernandezs records that show he was providing an hour of psychotherapy each day he saw her in the hospital.
She also denied ever using crystals or other unconventional therapy with Hess and said she never sent Hess to a psychic named Rianna, though she said she herself had visited the intuitive.
Her testimony was contradicted by several earlier exhibits in which Hess, Fernandez and hospital nurses noted Deckers use of new age techniques.
Perhaps even more confusing to the jury, Decker denied that she ever treated Hess from the time she left the hospital in May 1991 until January 1992. Jurors already have heard testimony from both Hess and Fernandez that Decker provided therapy for Hess weekly during that time.
It was during that period that Hess said she read the book Courage to Heal, about recovering from abusive relationships. Hess witnesses have said the book is extremely suggestive and could be the source of some of Hess satanic memories, which also started to emerge at the time.
Decker said she has given some of her patients suggestions to read the book, but said she had no memory of telling Hess to read it.
Of clear help to Fernandezs case was Deckers testimony that Hess was suicidal well before she met Fernandez and that her supervisors never expressed concern that her therapy could be harming Hess.
On the other hand, she aided Hess by saying all hypnosis after May 1991, including the time satanic abuse memories were recovered, was conducted by Fernandez.
August 25, 1999
- Psychiatrist: Fernandez was not negligent in his treatment of Hess
By Amber Paluch
Wausau Daily Herald
A Milwaukee psychiatrist testified Tuesday that Juan Fernandez III was working within the accepted standard of care when he treated Joan Hess for multiple personality disorder.
Dr. Harold Harsch, an associate medical director of psychology at Froedtert Memorial Lutheran Hospital in Milwaukee, told the court Fernandez was obligated to treat Hess for the disorder, also known as MPD, whether he believed her memories of sexual and satanic ritual abuse were real.
Although doctors can produce short-term, minor changes in a patients behavior and thinking, theres no case of complex memories being clinically implanted, Harsch said. There is nothing in the records or testimony studied to indicate Fernandez suggested the memories or MPD-like behavior, he said.
Hess is suing Fernandez in Marathon County Court, alleging he convinced her using hypnosis during four years of therapy that she had suffered abuse by her family and members of a cult in Ladysmith.
Harsch testified he believes Hess memories are false or embellishments of fact. But he disagrees with the idea that Fernandez was negligent in his care of Hess and implanted the memories, leading to the MPD.
Fernandezs approval of the hysterectomy Hess wanted because of her emotional distress at the sight of blood was reasonable, Harsch said. Her hospitalizations were justified and designed to protect her from her suicidal tendencies. Fernandezs decision to discontinue treatment with her was handled professionally and with courtesy to Hess. And he regularly reassessed Hess and reconsidered his diagnosis of her, Harsch testified.
Hess lawyers argued Fernandez only re-evaluated Hess in the spring of 1991 to determine her MPD was due to childhood sexual abuse, and he did not rethink the idea after.
Fernandez got a second opinion on his treatment plan later than he should have and only to ask about treatment options -- not to question his diagnosis of MPD, William Smoler, Hess attorney, argued.
Carolyn Decker, Fernandezs partner at the time he treated Hess, is expected to testify today, followed by a cross-examination of Fernandez. Jury deliberations are expected to begin by the end of the week.
August 24, 1999
- Doctors defense: Hess capable of returning to work
Ex-mayors ex-wife claims mental illness has permanently disabled her
By Amber Paluch
Wausau Daily Herald
A vocational consultant and a psychoanalyst testified Monday that Joan Hess is capable now of returning to work, despite her assertion she is permanently disabled.
Lawrence Hollingsworth, an Eau Claire consultant who evaluates the potential impact of conditions on employability, added that Hess would benefit from the social interaction that comes from working with others.
Hess is suing Juan Fernandez III, her psychiatrist from 1991 to 1994, in Marathon County court for allegedly using hypnosis to implant in her mind false memories that she was sexually abused as a child by members of a cult, including her parents.
Fernandez convinced her the memories were real and that she had developed dozens of personalities in response to them, Hess said. As a result, she said, she tried to kill herself several times and her mental illness destroyed her life.
Mondays testimony was relevent because, if the jury finds Fernandez negligent in his treatment of Hess, jurors could consider Hess employability in assessing damages.
Hollingsworth testified Monday that based on his review of Hess records, trial testimony and her personnel file from Wausau Hospital, Hess now lacks only the motivation to work full time.
Hess has already demonstrated her ability to work by maintaining a 13-credit student workload at Northcentral Technical College to continue her education beyond a nursing degree she earned in 1989, Hollingsworth said. The market holds a number of nursing opportunities in fields with various schedules and stress levels.
But jobs with the flexibility that Community Health Care Wausau Hospital was temporarily allowing Hess to work are rare, Hess lawyers said. Therapists have reported Hess has difficulty concentrating and needs an excessive number of rest periods to work.
Although she wants to work and has the motivation, her emotional problems limit her employability, her lawyers said.
Hess left school early this year to care for her sick father. Her lawyers maintain that therapy with Fernandez left Hess with emotional scars that will limit her ability to work in the future.
Walter Davison, a psychoanalyst at Columbia Hospital, testified that when he evaluated her in April 1998 he saw no signs of permanent scars that would limit Hess employability.
He also told the court he saw no reason for her to require future psychiatric hospitalization because of her history, as Hesss witnesses have said she will almost certainly need.
It sounds to me like shes faced the most frightening things you can face -- those fantasies, Davison said. And having done that, what can scare you?
His testimony contradicts that of six other witnesses who have testified that Hess might not be capable of ever going back to work, her lawyers told the court.
Davison did not spend the amount of time with her that other therapists with differing opinions had, her lawyers said.
Davison said Hess has the ability to rise above her emotional problems. She received high grades in her 1998-99 NTC classes and showed concentration when he interviewed her.
Mrs. Hess during my evaluation appeared rock solid in many ways, Davison said.
Hess lawyers argued she was unable to maintain a household and take care of her husband and children because of her emotional problems, and her situation became increasingly worse as therapy with Fernandez continued.
August 21, 1999
- Expert softens his position in cross-examination
Spiegel says Hess never had memories implanted
By Amber Paluch
Wausau Daily Herald
Dr. David Spiegel, M.D., said Friday Dr. Juan Fernandez III used the appropriate treatment while acting as Joan Hess therapist.
Spiegel, a psychiatrist and full professor at Stanford University School of Medicine in California, said Fernandez made a reasonable diagnosis of Hess condition, used reasonable and consistent treatment, continually re-evaluated her, involved other professionals and consultants in her care and applied treatment that was standard and appropriate at the time.
Hess is suing Fernandez in Marathon County court, claiming that using hypnosis, he implanted in her mind memories that she had been abused by her father and other family members who belonged to a cult in Ladysmith.
Fernandez convinced her she had developed dozens of personalities in response to the memories, Hess said, and her mental illness destroyed her life.
Spiegel has written more than 160 articles related to hypnosis and psychiatry and published five books and a number of chapters in other books. He sees patients with Multiple Personality Disorder, which is now referred to as Dissociative Identity Disorder, and has hypnotized at least 5,000 patients.
Spiegel told the court hes never seen a case of MPD caused by a doctor implanting suggestions in a patients mind. He also said in his review of treatment records and the previous depositions in Hess case against Fernandez, Fernandez did not implant memories in Hess while she was under hypnosis.
But that doesnt mean it didnt happen, Hess lawyers argued. Because only Hess and Fernandez were involved in the unrecorded treatments involving hypnosis and Hess was unable to clearly know what took place during the treatment; no evidence of suggestion doesnt mean it didnt exist.
People who are able to be hypnotized fall in and out of hypnotic states constantly, Spiegel said. The therapist needs to establish and maintain a trust with the patient, limiting his ability to challenge her memories even if he finds them unrealistic, Spiegel said.
It wouldve been below the standard of care if Fernandez had not helped Hess explore and deal with the memories she recovered through hypnosis, Spiegel said.
Patients can have inaccurate memories and are vulnerable to suggestions while under hypnosis, he said. Verbal prompts, body language and special attention, encouragement or reinforcement can influence the patients memories.
Hess lawyers also questioned Fernandezs competency in placing Hess under hypnosis with little formal training. Hypnosis began in the fall of 1991, but Fernandezs first training specifically on the topic of hypnosis did not come until March 1992.
Spiegel said he wouldve preferred a doctor with Fernandezs training to learn more about the complexity of using hypnosis to recover repressed memories before performing it, but learning through experience is just as effective.
Spiegel said hes in the middle of the spectrum on the controversy of whether MPD exists, but agrees that the disorder can occur, and its possible that MPD conditions could be implanted in a person, but there is no evidence at this point.
Theres no evidence because no test could ethically be performed where a doctor implanted false memories in a patient for a long period of time, Hess lawyers said.
Spiegel said Hess was angry and felt let down when Fernandez ended her therapy, and sought a lawsuit soon after.
August 20, 1999
- Expert softens his position in cross-examination
Psychologist says therapy may have contributed to Hess' condition
By Peter J. Wasson
Wausau Daily Herald
Massachusetts psychologist Daniel Brown spent all of Wednesday bolstering the defense assertion that Juan Fernandez III could not possibly have caused Joan Hess' mental illnesses.
Brown continued that course during direct examination Thursday morning. But within an hour of beginning his cross-examination with Hess' attorney, Brown began softening his position.
"I would say that there's certainly a possibility that therapy contributed" to Hess' condition, he said.
Hess is suing Fernandez, her psychiatrist from 1991 to 1994, for allegedly using hypnosis to implant in her mind false memories that she was sexually abused as a child by members of a cult, including her parents.
Fernandez further convinced her she developed dozens of personalities as a result of those memories and some of her alter personalities led her to attempt suicide on several occasions, Hess said.
Wednesday, Brown testified that he found no evidence whatsoever that Fernandez either implanted satanic abuse memories in Hess or contributed in any way to her multiple personality disorder, or MPD.
He continued Thursday morning by saying that hypnosis was the proper tool for Fernandez to use on Hess because it allowed him to communicate with her alter personalities and stabilize them.
Brown also said exploring memories of abuse helped about half of the MPD patients examined in a study, and half "is a pretty good track record" given the complexity of the disorder.
Finally, Brown said, MPD was a recognized diagnosis by 80 percent of the Veteran's Administration therapists surveyed in one study, in contrast to Hess's witnesses who claimed MPD is discounted by most professionals.
Hess attorney William Smoler then began his attack on Brown's credibility, first by pointing out that Brown co-authored a book with a Harvard University professor who believes that some mental illnesses are caused by alien abductions.
Smoler then challenged Brown's bias in favor of MPD veracity and his assertion that therapists can't implant in patients complex memories of abuse.
"It's not at all been scientifically established," Brown said. "There's not sufficient evidence to make that argument."
Instead, Brown said, it is likely that patients who report abuse at the hands of cult members, including such things as bestiality, baby murder and blood drinking, absorb those memories from elsewhere.
Most satanic abuse memories have at their core real incidents that abuse patients then embellish using material they absorb from books, movies, other patients and other sources.
Smoler then asked Brown to point out one scientific study that shows complex memories can be created by reading books or other sources, and Brown could not identify one.
Finally, Smoler used Brown to attack Fernandez himself. Fernandez testified earlier that, though he had little formal training in hypnosis before treating Hess, he had an extensive library on the topic that he constantly referred to in his practice.
Smoler had asked Fernandez to show those books to jurors. In the silent courtroom, jurors thumbed through the books that Fernandez said he frequently used with patients.
As they did so, the sounds of crisp pages and cracking book spines rang through the courtroom as the practically new and unused books were opened.
The implication that Fernandez wasn't nearly as versed in hypnosis as he claimed was clear, and Smoler used Brown to drive it home to jurors.
He ended his cross-examination of Brown Thursday by pointing to one of the psychologist's former writings:
"Hypnosis in the hands of someone poorly trained is dangerous," Brown wrote.
August 19, 1999
- Expert: Repressed memories are a real phenomenon
Witness testifies Fernandez not responsible for Hess' memories
By Peter J. Wasson
Wausau Daily Herald
A Massachusetts expert said Wednesday Joan Hess' memories of abuse and torture are either real or she created them in her mind from a number of outside sources.
Either way, psychologist Daniel Brown said he is certain Juan Fernandez III is not responsible for the memories.
Hess is suing Fernandez in Marathon County court, claiming he convinced her using hypnosis during four years of therapy that she had been abused by her father and other family members who belonged to a cult in Ladysmith.
Hess alleges that Fernandez also convinced her she had dozens of personalities that developed in response to those memories and that her mental illness eventually destroyed her life.
Brown, an expert in hypnosis and post-traumatic stress disorder, said Wednesday repressed memories are a real phenomenon, contradicting several Hess witnesses who said it is a hoax.
Brown explained that children who suffer severe trauma, such as sexual abuse, cannot tolerate the traumatic events and shut them off in compartments in their minds.
Over years, the memories remain dormant until they start to leak out and manifest themselves as the victims grow to adults.
In Hess' case, Brown said, it was apparent that the memories began to affect her in her late teens, when she had her first bouts with depression. As they progressively took over her consciousness, he said, she developed relationship problems, post-traumatic stress symptoms and finally multiple personalities.
Those personalities, or "alters," told Fernandez that Hess had been forced to witness cannibalism and murder as part of a cult to which her parents belonged and she eventually became a "breeder" for the cult and participated in bestiality.
Hess' attorneys said those memories obviously are not accurate because there were no medical records of Hess being abused as a child and there are no other reports of dead babies being found in Ladysmith.
But Brown said at once that the memories might be accurate and might be figments of Hess's imagination. More likely, he said, they're a combination of both.
He said there probably is a core of genuine abuse in Hess' history, perhaps her father kissing her on the lips after her mother died, as she has reported.
Over the years, that fact grew in her mind, and she "distorted and embellished" it by adding facts from books, movies and other sources, he said. As the memories garnered her attention from Fernandez, her family and other patients, she created even more, he said.
Brown then explained to the jury how Hess could have repressed memories of her father molesting her or even of cult members abusing her.
It's common, he said, for abuse victims to repress such memories in a phenomenon called "dissociative amnesia." After the childhood memories are compartmentalized and sealed off, they return to a victim's consciousness when the victim is exposed to stress or other stimuli.
In order for a therapist to implant horrific memories, he said, he would first need an easily-suggestible patient. Second, he said, he would have to deluge the patient with a continual barrage of intentional misinformation and repeat it over months or years.
Brown said even Hess acknowledged that Fernandez never did that to her. At most, Hess testified, Fernandez encouraged her to fabricate abuse memories through body language and other cues.
"I couldn't find one single suggestion of it (implantation by Fernandez)" Brown said.
Brown went on to suggest that Hess fell prey to "misinformation and propaganda" of false memory doubters during and after her treatment by Fernandez, and that even her attorneys worked to convince her that she was victimized by Fernandez.
Hess' attorneys will begin to cross examine Brown today.
The trial, which started July 26, is expected to last until Aug. 27.
August 18, 1999
- Fernandez defends treatment of Hess, but makes concessions
Therapist denies doing anything inappropriate
By Peter J. Wasson
Wausau Daily Herald
Juan Fernandez III spent Tuesday morning again defending his treatment of Joan Hess and denying that he did anything inappropriate while providing her therapy from 1991 to 1994.
Fernandez said he had no other options but to treat Hess with hypnosis and psychotherapy when she developed multiple personality disorder in 1992.
My own understanding of the alternatives would have been that I either treat this lady or I dont, Fernandez told his own attorney and the jury. There were no viable alternatives.
But Tuesday afternoon, Fernandez was subjected to his first cross examination and was forced to concede that his therapy itself might have contributed to Hesss mental illness.
Hess is suing Fernandez claiming that he implanted in her mind memories of sexual and satanic abuse at the hands of her father and other family members, including a nun.
Fernandez convinced her those memories were real, Hess said, and that she had developed dozens of personalities in response to them. As a result, she said, she tried to kill herself several times and will bear scars of the therapy forever.
Fernandez said Tuesday that he became something of a local multiple personality disorder (MPD) expert soon after he arrived in Wausau in 1990, but that he never intended to adopt such a role.
Other therapists, he said, sent him MPD patients because he was the only one who would treat them and he felt an ethical duty to help.
He felt he was helping Hess, he said, by helping her uncover memories of childhood sexual assault and refusing to either confirm or deny the accuracy of those memories. To tell Hess the memories either were or were not real, he said, could have led her to suicide.
When he became unsure of Hesss progress, he sent her to Milwaukee psychiatrist Nancy Perry, who confirmed that he was treating Hess properly and had diagnosed her accurately.
By the time Hess left his care, Fernandez said, she was definitely improving as a result of his therapy.
But under cross examination by Hess attorney, William Smoler, Fernandez was forced to back away from that position.
In 1991, when he started seeing Hess, she had never before been hospitalized in a psychiatric unit, was still married to former Wausau mayor John Hess and her children had never been in therapy, Smoler said.
Fernandez admitted that, by June of 1994, Hess was reporting memories of having sex with dogs and was complaining that her marriage was over and her children could be lost to her forever.
Smoler next addressed the question that has been at the heart of the trial since it began more than three weeks ago: Where did those memories of bestiality, sexual abuse and baby-eating come from?
Fernandez agreed there were three possibilities:
n The memories are accurate and true.
n The memories are false and Hess made them all up to get attention or for some other reason.
n The memories were false and implanted or absorbed from someone or somewhere else.
Fernandez would not say that he viewed the memories as inaccurate, but agreed it was very difficult to believe a nun was raping babies and eating them in a cult.
He also said he never had any indication Hess made the stories up just to get attention.
That left Fernandez with no other conclusion but that the memories were either implanted or absorbed, and he could offer five sources for them: Other MPD patients, books Hess read, treatment by another counselor, group therapy sessions or new age therapies involving crystals and psychics with Fernandezs partner, Carolyn Decker.
The only person who was aware of all those possible sources of memory contamination and the only one who had control over them was Fernandez himself, Smoler said.
August 17, 1999
- Fernandez denies accusations
Psychiatrist: Hess was treated as a textbook case
By Peter J. Wasson
Wausau Daily Herald
Juan Fernandez III did nothing to suggest or implant in Joan Hess the idea that she had multiple personality disorder, he said Monday during testimony in his malpractice trial.
He did nothing to suggest or implant memories in Hess that she was the victim of childhood sexual abuse at the hands of her father, he said.
He did nothing, he said, to suggest or implant memories that Hess was brutalized by a satanic cult while growing up in Ladysmith, he said.
Fernandez, the only witness to testify Monday, spent the first portion of his time on the stand flatly denying the accusations made by Hess witnesses during the first three weeks of the trial.
Hess suit claims Fernandez implanted memories of abuse in her during their therapy together from 1991 to 1994. As a result, the suit claims, Hess developed dozens of different personalities, some of which caused her to attempt suicide.
Hess witnesses told jurors multiple personality disorder (MPD) is not a genuine disease and that it is almost entirely produced by therapists improperly using hypnosis.
Fernandez said Monday he was completely unaware in the late 1980s and early 1990s that there was a raging debate in the psychiatric community over the MPD diagnosis. He also said he was unaware of any evidence that hypnosis can implant memories in patients and cause MPD symptoms, as Hess witnesses said.
In fact, Fernandez said Joan Hess was a classic textbook case of multiple personality disorder, then he produced a textbook to prove it.
Fernandez said he and other classmates in the psychiatry residency program at Michigan State University used the text Synopsis of Psychiatry during the late 1980s. He used a 1991 edition of the book in his practice and testimony Monday.
According to the text, MPD is a genuine disorder found almost exclusively in adults who were abused as children, frequently by family members. The book refers to MPD as a once-rare disease that was being diagnosed more often at the time by therapists becoming more aware of its causes.
The section on MPD said patients sometimes have alter personalities that adopt proper names, and others take on the names of their attributes. Many of the alters are children, the book said.
Hess had all of those symptoms and more outlined in the text, Fernandez said, and he followed the text in his treatment of her.
The book suggested that MPD patients be treated with hypnosis and therapy in an attempt to reintegrate personalities into one being, or at least to get them to the point that the patient can function.
To communicate with the alters, the book said, the therapist often must use hypnosis to contact them. The therapist must then make contracts with some of the alters to try to control them.
Finally, the authors suggested using anti-depression and anti-anxiety drugs to help MPD patients.
Thats my treatment, right there, Fernandez told jurors.
Fernandezs attorneys also spent several hours Monday trying to show jurors that all of Hess problems began well before Fernandez started treating her in February, 1991.
From early 1991 to May of 1992, local counselor Carolyn Decker, now Carolyn Muir, was the only one providing therapy for Hess, Fernandez said. He was only responsible for medicating her.
It was during Deckers therapy, which included the use of hypnosis, crystals, psychics and other new age techniques, that Hess first had memories of her father molesting her, Fernandez said.
Fernandez said he was never told of Deckers techniques and Hess never expressed anything but approval of the therapy.
By the time he took over Hess therapy in May 1992, she was being bombarded by sexual abuse memories, having flashbacks and already was showing signs of MPD, Fernandez said.
He had absolutely no control over Deckers therapy, he said, and no authority to tell Hess to stop seeing her.
Hess witnesses have told jurors that a psychiatrist is the captain of the ship in a patients treatment and that, even if not directly involved in therapy, the psychiatrist is responsible for it.
Fernandezs testimony is expected to continue today and perhaps into Wednesday.
August 15, 1999
- Defense ready to answer Hess' claims
By Peter J. Wasson
Wausau Daily Herald
For three weeks the jury has been deluged with information, but they've only heard one side of the story.
That story, the story of Joan Hess' treatment by psychiatrist Juan Fernandez III, has been bleak and oftentimes gruesome. She claims in her suit against Fernandez that the doctor used hypnosis to implant in her mind memories of sexual and satanic abuse.
It's up to jurors to decide where those memories came from, who is responsible for them and just how badly they harmed Hess, her ex-husband former Wausau Mayor John Hess and their children.
Much of the trial's focus thus far has revolved around multiple personality disorder (MPD) and recovered/repressed memory syndrome and the controversy over those alleged maladies.
Hess and her attorneys concluded their case Friday and Fernandez's attorneys will begin their defense Monday. They will be trying to answer, on Fernandez's behalf, the issues raised over the past three weeks by the plaintiffs:
-- Did Hess suffer from MPD and, if so, where did it come from?
The psychiatric community is polarized over the MPD diagnosis and Hess attorneys called several witnesses on the non-belief side of the debate. The debate began in the late 1980s and continues today.
Hess originally sought treatment from local therapist Carolyn Decker, now known as Carolyn Muir, for some depression, marital and work struggles she was having. At the same time, her family physician prescribed an anti-depression medication for her.
Within a few months, despite Decker hypnotizing her, Hess's depression was not improving and she complained of side effects from the medication she was taking. Decker referred her to Fernandez in February 1991 to prescribe new drugs.
Hess continued seeing Decker and started seeing Fernandez periodically for medication assessments. But by May 1991, the depression had deepened and Hess, suicidal, was admitted to Wausau Hospital's psychiatric ward.
There Fernandez, who admitted her, began taking over Hess's treatment as Decker continued with therapy and hypnosis. During this stay Hess, who had never reported such memories before, recalled during hypnosis an incident in which her father sexually fondled her.
In ensuing months, Fernandez gradually became Hess's only therapist and took over her hypnosis as well. Hess's witnesses have testified that they had never heard of using hypnosis in what they described as an easily-treatable depression case.
Essentially, Hess and her attorneys believe Fernandez hypnotized Hess with very little training, then suggested to her that her depression was caused by hidden memories much worse than her father fondling her.
Hess, her witnesses testified, and adopted those suggestions and expanded upon them. Within months, she reported to Fernandez that her father not only had fondled her but had raped and brutalized her as a child.
MPD supporters believe children who are subjected to extreme trauma defend their fragile minds by "forgetting" what happened to them and, in essence, assigning those memories to a place in their minds where another "personality" adopts them.
The memories lie dormant until the victim matures, then they come out through those personalities. By 1993, Hess was expressing memories of her father and other family members through dozens of personalities she said Fernandez "called out" of her during hypnosis.
Hess's witnesses, most of whom are MPD doubters, said Fernandez was negligent by using hypnosis improperly and making inappropriate suggestions while Hess was under hypnosis.
"I suppose the kindest thing you could say about the memories that developed in Joan in this case is that they're highly suspicious," Washington State psychiatrist Elizabeth Loftus said.
"Whenever you see a situation where somebody goes from having no memories of abuse and sexual brutalization to years later believing and having memories of being raped and drinking blood and being in satanic rituals with candles and robes and the whole works, it's natural to ask what went on in between and to try to examine the materials that are available for the sources of suggestion that could be responsible for the creation of those memories."
Fernandez's attorneys, who begin their case Monday, are expected to call several of their own expert witnesses to testify that MPD is a real disease and that Fernandez's use of hypnosis and memory recall was a commonly-used treatment in the early 1990s.
They will say Hess's mental illness progressed naturally and that Fernandez had nothing to do with making her worse.
-- Were the memories real?
Hess testified that she came to believe the memories of Satanism, sexual abuse and bestiality entirely. The memories were so convincing, she said, that she severed all relations between herself and her family and her father.
Eventually, she said, she even filed suit against her father claiming that he should pay for the abuse to which he subjected her. She later dropped that suit when she began doubting the memories.
Today, she said, she is just as certain the abuse never happened, and witnesses agreed. If there was a cult in Ladysmith, where Hess grew up, that was killing babies and raping children, where were the victims?
After the memories came to her, she said, Hess tried to verify them. She spoke to family members and, at Decker's suggestion, even visited a psychic. There was nothing in her medical records or family history to support any of the abuse.
Other experts have testified that this is another area in which Fernandez was negligent. It was his responsibility, Milwaukee psychiatrist Herzl Spiro said, to try and prove or refute the memories before treating them as factual.
As their therapeutic relationship grew, Hess said she came to view Fernandez as a hero, the only person who could cure her of her terrible illness. Fernandez, she said, encouraged those feelings.
Fernandez became the main authority figure on Hess's life, witnesses said, and by treating her memories as factual, Fernandez reinforced them in Hess's mind and encouraged her to continue developing new memories and new personalities.
Fernandez's attorneys are expected to present witnesses who will say it is not a psychiatrist's job to investigate memories or make any judgments about their accuracy.
It is a psychiatrist's job to do just the opposite, they will say. A therapist must remain neutral and never pass judgment on anything a patient says. In several depositions taken before the trial, Fernandez never specifically said if he did or did not believe Hess's memories.
-- Who is at fault?
There is no question that the hypnosis and memories of fondling began while Decker was treating Hess, and Decker already has acknowledged some responsibility and paid a $10,000 settlement to the Hess family.
As Decker was hypnotizing Hess, Fernandez was primarily responsible for Hess's medication. But that doesn't absolve Fernandez of responsibility, Spiro said.
The moment a psychiatrist gets involved in a patient's care, Spiro and other witnesses said, he becomes "captain of the ship." As a medical and psychological expert, he is in charge of all aspects of the patient's care.
Even though he wasn't seeing Hess for therapy, Fernandez was getting regular reports from both Hess and Decker about therapy sessions, so he knew what was going on.
While he couldn't order Hess to stop seeing Decker or order her to stop hypnotizing Hess, it was his job, Spiro said, to prevent harmful treatment.
Worse, Spiro said, Fernandez continued the same treatment plan when he took over Hess's therapy. He never made a complete diagnosis or developed his own treatment plan, Spiro said.
Spiro said all patients must give doctors "informed consent" to proceed with treatment. It is a doctor's responsibility to tell a patient all of the risks of therapy and present alternatives so the patient can make informed choices.
Fernandez never did that, Spiro and other experts said.
He also didn't do the one thing all doctors are taught to do, Spiro said: Stop treatment and reassess therapy when a patient is clearly getting worse. When she came to Fernandez, Hess had never before been hospitalized for psychiatric reasons and had no history of anything but brief and normal depressions, witnesses said.
By the time treatment ended, Fernandez hospitalized Hess 14 times, she tried on several occasions to kill herself and she lost all capacity to care for her children or even go out in public.
Furthermore, it was Fernandez's responsibility to prevent Hess from reading suggestive books or coming into contact with other MPD patients because information from either source could "contaminate" her memory.
Spiro said the fragile mind of a hypnosis patient can easily adopt and expand upon stories from books or other patients, and Fernandez allowed or encourage Hess to read several books about sexual abuse, satanic torture and MPD.
In addition, Spiro said, Fernandez put Hess in a support group with his other MPD patients, and in that group they spoke about their memories, promoting contamination.
Fernandez's witnesses will tell jurors that Hess's problems began with Decker and, by the time Fernandez started treating her, she was already developing MPD. His treatment from then on was responsible and acceptable, they will say.
In addition, they will testify, no doctor can control all areas of a patients life and Fernandez did, in fact, try to restrict Hess's reading material.
-- How badly damaged was the Hess family?
If jurors believe Fernandez was negligent and responsible for damages Hess and her family suffered, they will decide how much Fernandez should pay them.
Several witnesses, including Hess's current therapist Ron Potter-Efron, have testified that Hess is emotionally incapable of returning to work and likely will never be able to work as a nurse again.
She still is mired in depression, still is on medication and likely will see a counselor for the rest of her life, witnesses said.
As a result, Hess said, she cannot maintain concentration, energy or confidence long enough to hold a job.
A psychiatrist and economist testified Friday that Hess's future medical bills and lost wages alone total as much as $1.25 million. But it's impossible to place a value of the pain and suffering the entire Hess family endures, her attorneys said.
While they have not directly blamed Fernandez for the divorce between Hess and her husband, former Wausau mayor John Hess, witnesses have said it played a part.
Furthermore, Fernandez's treatment destroyed the relationships between Joan Hess and her children and her father, who now is dying of cancer. She again is speaking with her father, but Joan Hess spent five years refusing to have any contact with him.
Jurors would have to place a dollar value on those injuries and try to evaluate the pain Hess suffered by coming to believe she was the victim of sexual and satanic abuse.
While they have in no way conceded Fernandez's responsibility, his attorneys already have begun refuting the testimony of Hess's witnesses by claiming she simply has chosen not to return to work and is capable of doing so.
Their witnesses will say Potter-Efron released Joan Hess from weekly psychiatric visits in January and she since has not worked because she wants to be with her dying father.
August 14, 1999
- Hess' attorneys amount losses up to $1.25 million
Experts figure compensation by medical bills, lifetime of being unable to work
By Peter J. Wasson
Wausau Daily Herald
Jurors have heard for three weeks about the pain, turmoil and agony Joan Hess suffered while under the care of psychiatrist Juan Fernandez III.
Friday, her attorneys ended their case by trying to attach a dollar figure to that alleged negligence by putting a value on Hess's medical bills and work losses.
Hess claims that due to Fernandez's negligence, she can no longer work as a nurse and perhaps never will be able to. In addition, she likely will go through therapy, take medication and face psychiatric hospitalization for life.
An occupational therapist and economist testified Friday that, to compensate for those future costs, Fernandez would have to pay Hess between $865,000 and $1.25 million today.
Hess is suing Fernandez, claiming he used hypnosis to implant in her mind devastating memories of her father sexually abusing her and subjecting her to torture by a satanic cult as a child.
Hess alleges that she went to Fernandez in 1991 suffering from mild depression and stress over her job and marriage. By 1994, she said, she had developed dozens of personalities and was barely able to function as a mother, wife or employee.
Dane County psychologist and vocational therapist Ross Lynch said Friday that Hess has very limited value as an employee of any sort and likely is of no value as a nurse.
Lynch said Hess, as a result of her mental illnesses, can no longer be depended upon to make the critical, life-and-death decisions a nurse must occasionally make.
He said he examined Hess in 1998 and found her to be bright and determined to work well. But when subjected to stress, he said, she simply collapsed and was unable to maintain concentration long enough to complete tasks efficiently.
At best, he said, she could expect to work part-time in an unskilled or semi-skilled job, such as data entry or as a doctor's clerk filling out insurance forms.
Extrapolated over the expected life of her career, University of Wisconsin finance professor James Johannes said, Hess, 44, would have earned the equivalent of $438,236 in 1999 dollars and another $118,000 in benefits.
Johannes used economic statistics to determine how much money Hess would need now to equal her lifetime earnings and medical costs if she took all of that money now and invested it in government bonds.
If Hess worked to age 57 in part-time clerical work, she still would lose $865,000 compared to what she would have made as a nurse. If she worked to age 65, he said, she would lose $1,029,000 in 1999 dollars.
If, as some experts have testified, Hess can't even hold a clerical job and never will work again, it would take $1.25 million to compensate her for her losses.
Defense attorney Tom Rusboldt pointed out to Johannes that Hess' medical needs in the future are completely uncertain and that defense experts will testify that Hess is capable of returning to work today.
Johannes said that, as an economist, he had no opinion on Hess' capability to work, and he was relying upon Hess' doctors to estimate medical costs.
Rusboldt and defense attorney Paul Grimstad will begin their case for Fernandez Monday. They did not say how the case will progress, but Fernandez is expected to testify during the remaining two weeks of trial.
August 12, 1999
- Psychiatrist: Hess diagnosed improperly
Doctor feels Fernandez was continuously negligent with his treatment
By Peter J. Wasson
Wausau Daily Herald
If Juan Fernandez had performed as well on his medical exams as he did while treating Joan Hess, he would not be a doctor today, a psychiatrist who helped design board exams said Wednesday.
Milwaukee Psychiatrist Herzl Spiro testified Wednesday that he reviewed all of the records concerning Fernandezs treatment of Hess from 1991 to 1994 and found almost every area of that care negligent.
The care was negligent, he said, because starting with the first day he began as her psychiatrist, he diagnosed and treated her improperly. From that first moment on, he said, Fernandezs treatment was a disaster.
He fell terribly short of his duty to this patient, Spiro said. Its my opinion that those failures were directly responsible for the severe damage she bears today.
Hess is suing Fernandez claiming he used drugs and hypnosis to implant in her horrific memories of sexual and satanic abuse at the hands of her parents and other family members.
She testified earlier in the trial that she first was referred to Fernandez suffering from nothing more serious than mild depression, some troubles at work and in her marriage to former Wausau mayor John Hess.
Spiro agreed Wednesday that Hess suffered from depression and said it was a relatively easy case to work with had it been handled properly.
Fernandez also originally diagnosed Hess in February 1991 with depression, but then embarked on a course of therapy that no responsible doctor would suggest to a patient, Spiro said. The treatment included using hypnosis to delve into hidden memories Hess might have had of childhood abuse.
All conventional wisdom at the time dictated treating depression patients using medication and one of several different types of counseling, Spiro said. If used properly, such treatment is very successful in making patients better.
Instead, everyone agrees, Hess got worse. By May 1991, she was suicidal and hospitalized for a month in one of 14 hospitalizations she went through while under treatment by Fernandez.
While in the hospital and being hypnotized, Hess had her first memories of being sexually assaulted by her father, and hypnosis eventually revealed memories of her family being members of a cult that sacrificed babies and sexually tortured Hess.
To make matters worse, Spiro said, Fernandez never took the standard steps of evaluating his patients recovery and assessing whether his treatment was helping.
This woman was put through terrifying experiences in hypnosis, said Spiro, the only witness to testify Wednesday. The first thing you want to do is protect this woman from those terrifying experiences: Stop the hypnosis.
Instead, he said, Fernandez blindly forged ahead with his diagnosis and treatment. By November of 1991, Fernandez diagnosed her as suffering from depression and post-traumatic stress disorder, and he eventually added diagnoses of multiple personality disorder and satanic ritual abuse victimization.
Its very hard to describe the suffering this womans been through, Spiro said. Its heartbreaking. The pain and agony are just indescribable.
As a result, Spiro said, Hess developed dozens of different personalities, lost her ability to work as a nurse, be a mother or wife or carry out any of her other responsibilities.
Spiro said he suspects Hess will face a lifetime of therapy, medication, occasional hospitalization and inability to work as she deals with flashbacks, depression and other scars of her treatment. Her therapy and medical bills will cost tens of thousands of dollars, he said, and her suffering is impossible to gauge.
Today, Hesss father and two friends are expected to testify, as is another psychiatrist who offered a second opinion for Fernandez during his treatment of Hess and cautioned against continuing it.
August 11, 1999
- Therapist testifies Hess recovery has been long, slow process
New counselors tried traditional therapy methods
By Peter J. Wasson
Wausau Daily Herald
Joan Hess was a mess in the summer of 1994 when she went to therapists Pat and Ron Potter-Efron.
After four years of treatment by psychiatrist Juan Fernandez III, she was constantly shifting among her dozens of personalities. She continually had new memories of childhood satanic and sexual abuse.
She was suicidal, depressed, unable to work and no longer had a relationship with her family. She hadnt spoken to her father for four years, she said.
After a year of therapy by the Potter-Efrons, Hess was no longer suicidal, Ron Potter-Efron said Tuesday. She was shifting personalities and having abuse memories only infrequently, and her personal life was recovered enough for her to return to work.
Hess blames almost all of her troubles on Fernandez. She testified earlier in the five-week trial that she went to Fernandez and therapist Carolyn Decker originally with marriage, mild depression and work problems.
By the time Fernandez ended their therapy, she said, he had used hypnosis to implant in her mind horrific memories of satanic abuse at the hands of her father and other family members.
Ron Potter-Efron said the road back to relative normalcy for Hess has been long, slow and difficult. She has had many setbacks and has lapsed back into suicidal depression on more than one occasion.
When she entered treatment with the Potter-Efrons, Hess steadfastly believed she had multiple personalities and that all her memories were real, Ron Potter-Efron said.
She insisted that her new counselors continue the hypnosis and memory-retrieval therapy that Fernandez started, he said, because Fernandez convinced her that was the only way to get better.
The Potter-Efrons disagreed. Ron Potter-Efron said he and his wife, who has not testified, decided to use traditional therapy techniques to keep Hess focused on her present, real-life problems.
They took no position on whether her memories were factual, but let Hess come to those conclusions herself.
As she has gradually renounced the idea she is a multiple, she has functioned on a higher level, Potter-Efron said. Every time she said, No, Im not a multiple, there has been progress.
Letting go of that idea has been difficult, Potter-Efron said, because Hess invested four years of her life in the belief that she really did have multiple personality disorder and devoted much of her identity and life to that belief.
During those years, Hess said, her marriage to former Wausau mayor John Hess crumbled and she no longer was able to be a good mother to their two daughters.
It was nearly impossible for her to admit that the therapy with Fernandez, who she viewed as her hero, had been a five-year walk down the wrong path of life, Potter-Efron said.
When youve had trauma like this, when youve had wounds like this, there is some question in my mind about whether youll ever recover, ever be normal.
Nevertheless, by early 1998, Hess was working again as a nurse, and by summer of that year she was again close to her father and the rest of her family, her depression was controlled by medication and she was in love with a new man.
Today, Potter-Efron said, Hess functions relatively well. But shell never be as healthy as she was before treatment with Fernandez, he said, and shell always have lingering effects of those years.
She will always be wounded, he said. She will always have scars. Those scars will not be erased from her soul. She will always have things to deal with that most human beings dont have to deal with.
Hesss attorneys are nearing the end of their case and today they are expected to call a Milwaukee psychiatrist to the stand as an expert on the standards of mental health care and damages Hess suffered.
August 10, 1999
- Former Hess therapist questioned diagnosis
Treatment ended when insurance money ran out, witness testifies
By Peter J. Wasson
Wausau Daily Herald
A former co-worker of Juan Fernandez III said Monday that Fernandez continued to counsel Joan Hess on her multiple personality disorder even after several other people raised ethical questions about the treatment.
Betty Cameron, who worked for Fernandez and treated Hess with him, also said Fernandez stopped treating Hess when her insurance money ran out and she owed him about $10,000.
Cameron, now a therapist at another local psychiatric firm, said she first raised questions about Fernandezs treatment of Hess in late 1993. She said she then told Fernandez she thought the multiple-personality diagnosis was wrong.
Hess and her husband, former Wausau Mayor John Hess, also questioned the diagnosis and raised more questions about Fernandezs professional judgment, Cameron said.
The conflict came to a head in December 1993, Cameron said, and Fernandez became very angry with the Hess questions.
The Hesses are suing Fernandez, claiming Fernandez implanted in Joan Hess mind false memories of being sexually abused as a child by her friends and family members, whom she came to believe were members of a cult in Ladysmith.
It is the latest in several such lawsuits across the country that have been filed as patients have accused doctors of destroying their lives by improperly using hypnosis and drugs to treat multiple personality disorder, or MPD.
Hess first went to another therapist, Carolyn Decker, suffering in 1991 from mild depression, stress over changes at work and some marital issues, she said.
She came to believe through hypnosis that her family used her in cult rituals, forcing her to witness and take part in sacrifices, bestiality and other horrors. At no time did Fernandez try to tell her those memories were anything but factual, Hess said.
Cameron said Fernandez never gave her any indication that he believed the satanic memories were false. In some cases, she said, they discussed how outrageous some of the recollections were but neither she nor Fernandez ever questioned their validity in front of the Hesses.
Joan Hess also has alleged that Fernandez stopped treating her only when her insurance company refused to make further payments. Fernandez then ended their relationship without providing new counseling, Hess claims.
Cameron also supported that contention, telling jurors that Fernandez had his secretary tell him how much his MPD patients owed him before getting rid of them in favor of patients who could keep up with their bills.
In 1993, Cameron said, Fernandez started group therapy with his MPD patients because it was more cost-effective than having individual sessions with them.
After Camerons testimony, Fernandezs attorneys continued cross-examination of Joan Hess, which was postponed last week for scheduling reasons.
Under cross-examination, Hess conceded that she began to seriously question her MPD diagnosis only after her attorneys gave her books on the subject.
She also said Fernandez never spoke to her about bestiality or some of her other bizarre memories before she had those memories, and he therefore could not have directly implanted them.
Hess is expected to conclude her testimony today, followed by her new therapist, Ron Potter-Efron.
August 6, 1999
- Witness testifies Hess suffered from multiple personality symptoms
Wausau Daily Herald
A witness testifying on behalf of Joan Hess admitted under cross-examination Thursday that she did suffer from all the symptoms that make up a multiple-personality disorder (MPD) diagnosis.
James Hudson, a psychiatrist and professor at the Harvard University School of Medicine, said MPD is listed in a textbook used by those in the psychology field to make diagnoses. And, he said, Joan Hess suffered from all the symptoms listed in the book that make up MPD.
Hudson made the statements under questioning from Paul Grimstad, a lawyer for Juan Fernandez III. Fernandez is being sued by Hess and her ex-husband, former Wausau Mayor John Hess, who claim Fernandez implanted false memories of sexual and satanic abuse while she was under his psychiatric care from 1991 to 1994.
Grimstads questions led Hudson to agree, because Fernandez was following proper diagnostic procedures and suggested treatment of the time, that Hess was properly diagnosed. That followed testimony from Hudson, though, who said diagnosing patients as suffering from MPD was quackery.
Some (patients) are diagnosed as schizophrenic and some are diagnosed as MPD, he said. Obviously, one of those is inaccurate.
Under Grimstads cross-examination, Hudson agreed that even if a patient believes she has memories of abuse as a 10-month-old -- which he said was physiologically impossible -- that she should be treated for the memories.
But he said the treatment should distinguish the truth of the memory.
In some fashion (they should be treated), he said. It is useful to make the distinction between whether it did or didnt happen.
Some of the testimony Wednesday surrounded who made the initial diagnosis of MPD patients in the area. Lawyers for both sides agreed that of eight cases discussed -- which Hudson said Wednesday constituted an unusual cluster -- Fernandez diagnosed three cases and other therapists diagnosed the other five. However, Hudson said it was his belief that Fernandez not only sustained the diagnosis, he might have helped the initial finding.
He likely did play a causal role, Hudson said.
Hudson admitted that, although he thinks MPD and other similar disorders are the work of bad therapy, the hospital at which he works in Boston has an entire unit that treats similar cases.
William Smoler, attorney for the Hesses, asked Hudson about another Harvard professor, who has written that psychological diseases are likely caused by alien abduction.
Hudson said just because someone at Harvard or his hospital makes claims, it doesnt give them credence.
The Hesses are suing Fernandez in Marathon County Circuit Court for unspecified damages in a trial that is expected to last another three weeks.August 5, 1999
- Statistician: Multiple personality cluster unlikely
Fernandez made up to 14 findings of the disorder
Peter J. Wasson
Wausau Daily Herald
A psychiatric statistician testified Wednesday that Juan Fernandez III diagnosed and treated far more multiple personality disorder patients in the early 1990s than an average doctor would have.
James Hudson, a psychiatrist and professor at the Harvard University School of Medicine, studies the causes and distribution of mental disease in the United States.
He said Fernandez was treating at least eight and as many as 14 MPD patients, including Joan Hess, in 1993 and that Fernandez was responsible for a cluster of MPD cases in the Wausau area.
Hudson did not say how many MPD patients he would have expected Fernandez to have treated, but said MPD was a rare disease until cases exploded in the United States during the late 1980s.
These are a lot of cases in a relatively short period of time, he said, when asked to assess the fact that Fernandez had 14 MPD patients within three years of arriving in Wausau. Were not talking about one case per decade.
Hess and her family accuse Fernandez of negligence in misdiagnosing and treating Joan Hess between 1991 and 1995. They claim Fernandez implanted memories of sexual and satanic abuse in Joan Hess mind while he had her under hypnosis.
Hudson said there were four possible explanations for the number of MPD patients Fernandez diagnosed and treated:
n Chance. Hudson said it was possible that chance played a role in the concentration of cases, but dismissed that possibility out of hand. He said having so many cases in such a small geographic area made chance occurrence impossible.
n Referral. Fernandez could have had so many MPD patients because doctors from all over the area were referring, or sending their MPD patients to him. Hudson said he dismissed that possibility because Fernandez was the first doctor ever to diagnose at least three of his patients.
Even if Fernandez were treating just those three and not as many as 14, Hudson said, it would qualify as a statistically-unlikely cluster because true MPD cases are so rare.
n Fernandez was a talented diagnostician. The only evidence Hudson said he found to support such a theory was that Fernandez said he read extensively about MPD and therefore might be more familiar with it than other psychiatrists in the area.
n Fernandez made mistakes in diagnosis. Hudson concluded that Fernandez must have been errant in diagnosing his MPD patients, and he pointed to several facts supporting the conclusion.
First, he said, Fernandez had no idea there was any controversy over MPD or repressed memory diagnoses, even at the time when the debate about it was raging.
Second, Hudson said, Fernandez said he was unaware that there is evidence that false memories can be implanted while a patient is under hypnosis. Finally, Hudson said, Fernandez apparently believes it possible there are satanic cults abducting people and sacrificing them in the area.
In fact, Hudson noted, Fernandez admitted in a deposition that he told Hess at one point in her treatment that another patient had told him of a cults presence near Wausau.
All of those facts, Hudson said, led him to conclude that Fernandez was improperly diagnosing patients, in effect creating MPD cases in Wausau.
Fernandezs attorneys tried to discredit Hudsons testimony by pointing out that studies available when Hess was in treatment supported MPD and repressed memories as legitimate diagnoses.
Paul Grimstad, one of Fernandezs attorneys, also showed that Hudson gets about a third of his income testifying in court cases, has never had a full-time private psychiatry practice and isnt a Harvard employee, though he is a professor there.
Hudson also conceded that he never reviewed all Hess case records and could not say she met some criteria for MPD while under Fernandezs care.
Cross examination of Joan Hess, which began Monday, is expected to be delayed again today so a Hess witness who specializes in the
August 4, 1999
- Expert: Psychiatrist was negligent in Hess case
Johns Hopkins director opposes MPD diagnosis
By Peter J. Wasson
Wausau Daily Herald
One of the foremost psychiatrists in the country testified Tuesday that he has no doubt Juan Fernandez III was negligent in several ways during his four-year treatment of Joan Hess.
Dr. Paul McHugh, director of psychiatry at Johns Hopkins University and chief psychiatrist at Johns Hopkins Hospital, is a longtime opponent of the diagnosis of multiple personality disorder, or MPD.
He said Tuesday that the overwhelming majority of MPD patients, including Hess, have their personalities and abusive memories implanted by irresponsible and poorly trained therapists.
Hess testified earlier that she originally sought psychiatric help in 1991 after a bout with depression and some problems with her then-husband, former Wausau mayor John Hess.
While under Fernandezs care, Hess said, she came to have vivid memories of being sexually abused by her parents and others who were members of a satanic cult in Ladysmith.
In response to those memories, she developed more than 75 personalities that ruled her life until she left Fernandezs care. Fernandez, she said, encouraged her to create those personalities while she was under hypnosis.
McHugh said genuine MPDs are rare, very, very rare cases. In fact, I only saw one patient up until the 1980s.
In the 1980s, he said, MPD cases exploded as a few psychiatrists began diagnosing and treating them. There are clusters of MPD cases in the areas around such doctors, he said, and almost no MPD cases elsewhere.
McHugh testified Tuesday that it is possible and even common for psychiatrists to implant memories and that some psychiatrists are in competition to see who can treat the most patients with the most memories.
McHugh said he reviewed Fernandezs work with Hess, and found Fernandez negligent in three ways:
- Professional techniques: McHugh said Fernandez never properly evaluated Hesss condition to determine what her real problems were. He then used hypnosis as a primary therapy tool with little or no training in the discipline, he said.
Fernandez also prescribed tranquilizers equivalent to drinking a case of beer a day, which made her far more susceptible to suggestions that she had alter personalities. Finally, McHugh said, Fernandez abandoned Hess treatment without ensuring that she was prepared to move to other treatment.
- Therapeutic focus: Instead of concentrating on her here and now problems of depression, work and family troubles, Fernandez delved into hypnosis-generated memories and alter personalities, McHugh said.
A doctors primary job is to get his patient healthy, McHugh said. In Hess case, that meant treating her depression, medicating her and making certain she was no longer suicidal. It might then be appropriate to explore her past, McHugh said, but never until she was stabilized.
- Clinical common sense: McHugh said Fernandez failed to use even a little common sense, especially given the outrageousness of some of the memories she reported.
When Hess started talking about memories of forced abortions, sexual abuse and other horrors, Fernandez never checked medical records, police records or spoke to friends and family members to determine if any of it was true, McHugh said.
He also endorsed mutilative surgery for psychic reasons, McHugh said, referring to the hysterectomy Hess had to remove the evil from her body.
Finally, McHugh said, Fernandez continued with hypnosis and memory retrieval, never changing his approach or technique, even when the patient continued to worsen over months and months and months.
McHugh and Hess attorney William Smoler then went through volumes of psychiatric textbooks, journals and professional articles dating back to the early 1900s in which MPD was dismissed as largely psychiatrist-generated.
During cross examination, McHugh agreed that Hess began having memories of sexual abuse before Fernandez ever hypnotized her and agreed that the American Psychiatric Association acknowledges the existence of MPD.
He also agreed that Fernandez got a second opinion from another psychiatrist who approved of the treatment being given to Hess.
Hess is expected to resume testifying later in the trial. Her cross examination was interrupted Tuesday and will again be postponed today to allow experts with scheduling problems to appear.
August 3, 1999
- $149,000 worth of therapy destroyed wife, Hess says
By Peter J. Wasson
Wausau Daily Herald
Joan Hesss treatment by psychiatrist Juan Fernandez III cost $149,000 over four years, including $45,000 for Fernandez and $48,000 to Wausau Hospital, Hess testified Monday.
For that price, Hess said, her life was destroyed.
Her memories became more and more bizarre, including bestiality and cult members abusing her with a knife.
The switching between her different personalities became so frequent she couldnt do normal activities. At one point, she said, a personality named Dack took over her consciousness.
According to the memories I was having (as Dack), there were babies born and killed, Hess said as her lawsuit against Fernandez entered its second week at trial. I would be handed a knife and told to kill them. It made me feel ... like I had actually murdered babies.
When she became convinced that the only way to rid herself of evil was to have a hysterectomy, her personalities conspired to try performing the operation on her at home using kitchen utensils, she said. She also tried killing herself several times.
Then, Hess said, it all ended. Fernandez refused to see her and other multiple-personality patients because the novelty wore off and he wanted to turn his attention to other clients.
Hess and her family claim Fernandezs treatment of her from 1991 to 1995 was negligent and that he implanted memories of abuse and torture in her mind. They are suing for unspecified damages.
After Fernandez stopped counseling multiple personality disorder patients, Hess began seeing a new therapist in Eau Claire. She demanded that the new therapist continue helping retrieve memories of satanic abuse because Fernandez told her such work was required for recovery, she said.
But the new therapist, Patricia Potter-Efron, refused to deal with recovered memories and concentrated on traditional psychological methods, Hess said, and the memories all went away. She no longer had dreams of satanic abuse. She finally started getting better.
Its been a lot of hard work, she said. The further I got from therapy with Dr. Fernandez, the more clear it got to me what is real and what is not real.
Although the memories have ceased, Hess said, the ramifications havent.
Its very hard to let go of the fact that I hurt my family and friends, she said. I dont feel like a freak like I did while I was in therapy. I dont feel crazy anymore. I feel like Ive lived a very long life in my 44 years.
Aside from her divorce, Hess blames Fernandez for making her so uncertain of herself that she can no longer hold a job as a nurse. She can no longer make responsible decisions, she said, cannot concentrate and has occasional anxiety attacks.
But the flashbacks are gone, she said, the voices in her head are gone and alter personalities havent made an appearance in more than two years.
But were all those symptoms Fernandezs fault? His attorneys got their first chance to question Hess Monday, a week after the trial started.
Under questioning by attorney Tom Rusboldt, Hess acknowledged she has never been an emotionally healthy person. Shes had bouts with depression going back to her childhood.
She also contemplated divorce several times before going to Fernandez, and was on the verge of suicide several times before he started treating her.
Hess also acknowledged her life was miserable before Fernandez became involved and her memory problems traced back to therapy with Carolyn Decker, when Hess started recalling sexual abuse at the hands of her father.
Fernandezs attorneys will continue to chip away at Hesss allegations today as they begin a second day of cross examination.
July 31, 1999
- Hess lawyers suggest money a motive
Hess said her insurance often stopped paying every year by summertime
By Peter J. Wasson
Wausau Daily Herald
Hess said her insurance often stopped paying every year by summertime
Joan Hess and her lawyers Friday suggested to jurors a motive psychiatrist Juan Fernandez III might have had for implanting memories of sexual and satanic abuse in Hesss mind.
When Fernandez started treating Hess in February 1991, he was seeing her occasionally and prescribing medication for her as part of treatment with therapist Carolyn Decker.
By the end of 1992, Fernandez had taken over all of Hesss treatment, hospitalized her several times and was seeing her at least once a week, often several times a week for hours at a time, Hess said.
Fernandez had just moved to Wausau and taken a job as a child psychiatrist at North Central Health Care Center. By late 1992, he had quit that job and was seeing more than a dozen multiple personality patients in private practice, all of whom presumably required treatment as intense as Hesss.
He also began counseling John Hess and their daughters, had started a support group for children of MPD patients and even spoke of opening his own MPD ward at the hospital, Joan Hess said.
Though her attorneys havent elaborated yet, they clearly were letting jurors know that Fernandez was making a lot of money. So much money, Hess said, that her insurance often stopped reimbursement by summer of every year.
Now the Hess family wants part of that money. They are suing Fernandez, claiming that his four-year treatment of the family was negligent and that he implanted the memories while he had Joan Hess under hypnosis. They are claiming unspecified damages, and Fernandez has denied the allegations.
Much of Fridays testimony by Joan Hess, the only witness to appear thus far, was intended to show jurors just how badly she and her family were allegedly damaged by Fernandezs treatment.
Fernandezs attorneys are expected to begin cross examination of Hess Monday. So far, jurors have heard nothing from the defense.
Through all of Fernandezs treatment, Hess said, she got worse and worse. In 1993, Hess said, her condition had gotten so bad that she was hospitalized 11 times for a total of 46 days.
On several occasions, she tried killing herself with prescription medication and alcohol, driving off Rib Mountain or other methods. She and her husband became alienated, and John Hess was concerned he would return from work and find her dead on the floor. They discussed divorce, she said.
Her children came home from school to find her playing with toys on the floor. She no longer spoke with her father and other family members, who she believed abused her, she said.
I was putting my whole family in the craziest situations, she said. They never knew from one minute to the next who I was going to be.
The voices in her head became so constant and loud she rarely could leave the house. She began mutilating her own body and having vivid memories of unspeakable abuse.
Finally, in June 1993, Hess complained to Fernandez that her monthly menstrual cycle gave her flashbacks to the satanic abuse she believed she suffered. With Fernandezs help, she had a hysterectomy in August.
It was really hard to discuss with people that I needed a hysterectomy because I was evil, she said. She said she believed her reproductive organs had been used for breeding and giving birth of the devils children.
Fernandez, in his own notes, discussed no doubts about Hesss diagnosis or history, Hess said. He maintained in his therapy notes an apparent belief that the childhood abuse Hess claimed to have suffered was real.
The cause of these disorders in 97 percent of the cases is severe childhood trauma, Fernandez wrote in a letter to Hesss insurance benefits coordinator. Indeed, this is the case with Joan.
July 30, 1999
- Joan Hess testifies about early therapy
She says mild depression soon became diagnosis of 75 personalities
By Peter J. Wasson
Wausau Daily Herald
It all started so slowly and with such seemingly minor problems.
Joan Hess first went to Wausau therapist Carolyn Decker in August 1990, complaining of the sorts of trouble most people go through -- stress, mild depression, lack of communication in her marriage.
In February 1991, Decker referred Hess to psychiatrist Juan Fernandez III.
By May 1991, Fernandez admitted her to Wausau Hospitals psychiatric unit for severe depression and suicidal thoughts, and by the end of her monthlong stay, Hess had recalled vivid memories of her father sexually abusing her as a child.
She had never before had any such memories, or even thoughts that her childhood was less than normal, Hess told a Marathon County jury Thursday as her lawsuit against Fernandez completed its fourth day in trial. She described her early life as idyllic.
Hess and her family, including former Wausau Mayor John Hess, blame Fernandez for implanting in Joan Hesss mind memories of abuse, murder, cannibalism and more. The family claims those memories haunt the 44-year-old Joan Hess today and have devastated their lives.
Im not an expert on psychology, Hess testified. I needed to trust someone. I went to these people for help, knowing they were experts on this subject.
Though the memories started surfacing while Decker had Hess under hypnosis, the Hess family is suing Fernandez because he was in charge of her treatment and continued hypnotizing her as her condition worsened, family members said.
As the hypnosis continued, the memories grew stranger. Joan Hess, the only witness to testify thus far, spent Thursday outlining her treatment by Decker and transition to therapy from Fernandez.
Following is an account of the therapy, according to Hess, her journal entries and notes kept by Decker and Fernandez:
n Feb. 8, 1991, Hess had her first visit with Fernandez. She had been seeing Decker as her only therapist and her family physician had been prescribing anti-depressant medication, but Hess asked for a new prescription and her doctor told her to find a psychiatrist.
Hess said she tried all the other local psychiatrists but none were taking new patients. Decker suggested Fernandez, who had just moved to the area.
During that first meeting, Hess complained of some difficulties with her stepmother and some continuing problems communicating with her husband. Fernandez gave her a prescription for Prozac, an anti-depressant.
n Feb. 15, 1991, Hess told Decker she was becoming more depressed as her body adjusted to the new medication. She made with Decker a no suicide contract, in which Hess promised to call several people before going through with any thoughts to harm herself.
n Feb. 26, 1991, Decker made the first suggestion that Hess be hypnotized after Hess said there were periods of her childhood that she couldnt recall. March 23, Decker hypnotized Hess for the first time at Deckers home, where it was more comfortable and relaxed.
During that session, I heard two things, Hess said. I heard my mothers voice calling my name and I heard a small child. ... I had the impression that was me.
Hesss mother had died unexpectedly after a brief battle with cancer when Hess was in high school, and she said hearing her mothers voice was incredible.
To hypnotize her, Decker had Hess relax on a sofa and stare at an object over her head. She then told Hess her eyes were feeling heavy and she was going down an escalator, going back to different ages in her life.
Hess said she never thought her spotty memory of childhood was abnormal or something to worry about until Decker insisted she dig deeper into her past.
n May 2, 1991, Fernandez admitted Hess to the Wausau Hospital psychiatric ward to keep me safe and to explore what might be in my past that was causing me to be so suicidal, Hess said.
During her monthlong stay, Hess had her first memories, retrieved during hypnosis, of unpleasantness in her childhood. She said she recalled her father touching her inappropriately and hearing her father forcing her mother to have sex.
n July 22, 1991, Hess had come to believe that her father repeatedly sexually molested her and that her mother was aware of it and permitted it, but all the proof I had has come from hypnosis, she wrote in her journal. Hess said she still had a hard time believing any of it was true.
n Sept. 26, 1991, Hess wrote in her journal of going to see a psychic at Deckers suggestion. The psychic told Hess she had been sexually abused 10 or 12 times by a 12-year-old, that there were no long-term repercussions of the abuse and that she was abused before the age of puberty, but that no intercourse occurred.
n Oct. 16, 1991, Hess reported that she was having flashbacks that appeared in her head like a porno flick of her father abusing her.
Its like a film strip where one picture will be there, then quickly change to another then another then another, Hess said. She said she couldnt make the pictures stop, and Fernandez prescribed an anti-anxiety drug.
n Nov. 17, 1991, Fernandez again admitted Hess to the hospital and he hypnotized her for the first time. The hypnosis process was similar to Deckers, but instead of descending to different ages, Hess descended to a long hallway lined with doors, behind which there were special rooms.
At first, there were only a few rooms, including a safe room, where she could go to escape and a spare parts room where she stored bits of flashbacks. The rooms eventually expanded to contain different locked-away personalities and a torture chamber in which she could punish her parents.
n Jan. 16, 1992, Hess began showing the first signs of having multiple personalities. She wrote a letter to her 15-year-old self, saying, You must have liked the attention you were getting or you would have tried to stop it (the abuse by her father). You could have told someone. You could have resisted his advances.
Hess said in her journal that she was beginning to feel like the child-person she was talking about in therapy, and that her husbands face and her fathers were becoming interchangeable in dreams.
n March 1992, Hess was again hospitalized for three days in the middle of her husbands mayoral campaign. Fernandez had her on five drugs and Hess was beginning to recall abuse by other family members, friends and neighbors. By April, Hess began recalling intercourse with her father at age 8.
n May 1, 1992, Hess was hospitalized again for three days and recalled being tied up and raped by her father, and remembered that he performed an abortion on her. A few days later, Fernandez reported in his notes the appearance of Hesss first two alter personalities, Bonnie and Betty, twin sisters. Specific people started to emerge, he said, and hypnotherapy revealed a group of parts ranging from a baby to an adult.
n May 12, 1992, a three-day television special report was aired on WAOW TV-9 in Wausau in which Fernandez and three of his patients, including a disguised Hess, told of their experience with multiple personality disorder. On the show, Fernandez stated MPD was a fact and was always the result of childhood sexual abuse. After the series aired, Fernandez mentioned to Hess that some of his patients recalled cult activity in their past, and Hess remembered rumors of a cult in Ladysmith where she grew up. The two began to investigate, Hess said.
By summer of 1992, Hesss behavior was becoming increasingly bizarre and Fernandez was the only one treating her. Despite the frequent hypnosis, she said, her condition steadily worsened.
She began writing letters to Fernandez in which she took on one of her other personalities.
Its unsettling to know we are not one, but many, she wrote. We know that Joan finds being aware of one or many of us at the same time confusing. We are We and we do speak and she does hear us.
Hess said she was frequently hearing voices, some of them giving her instructions to harm herself. She couldnt stop them, she said.
We are worried about our future, our ability to exist, Hess wrote in another letter to Fernandez. We all use so much of the bodys energy that we fear our demise. Joan is failing rapidly.
Hess eventually identified more than 75 personalities -- Jo Ann, the flirtatious woman John Hess married, 10-month-old Baby Joan, Missy, the first in line to pick a fight, Joan Marie, an adolescent in charge of all the younger personalities, and more.
As they presented themselves or were brought out through hypnosis, they would make it known what their role was (to) Dr. Fernandez, Hess testified.
Hess today believes none of the personalities existed, that she was never a member of a cult or abused by her father and that Fernandez implanted all the memories while she was under hypnosis.
She maintains that Fernandez was obligated to stop her treatment when she was so obviously getting worse and worse, and was negligent in continuing it.
Hess is expected to continue testifying today and into Monday.
July 29, 1999
- Hess trial centers on disorder, negligence
Family claims negligence, defense says right steps followed
By Peter J. Wasson
Wausau Daily Herald
Psychiatrist Juan Fernandez III moved to Wausau in 1990 after completing medical school in the Dominican Republic and a residency in Michigan.
Within months, he had diagnosed and was treating as many as 17 patients suffering from multiple personality disorder, according to attorneys in the Hess-Fernandez malpractice suit.
One of the patients was Joan Hess.
Even those who believe multiple personality disorder, or MPD, is a real disease say it is rare. How, then, did Fernandez find so many patients in such a small area? The question was left unanswered by Hess family attorneys.
Many questions, in fact, remain unanswered after Wednesdays opening arguments in the trial, scheduled to take five weeks.
Two questions are really at issue: Is MPD real, or a condition implanted by reckless and negligent psychiatrists improperly using hypnosis and other techniques, and was Fernandez negligent when he treated Joan Hess from 1991 to 1994?
As expected, lawyers for each side have very different answers to both questions.
Both agree Joan Hess, 44, was very ill during the time she was treated by Fernandez and that she came to believe she was sexually abused by family members as a child as part of a satanic cult. The cult also engaged in cannibalism, murder, bestiality and baby sacrifice, Hess believed.
Both sides agree Hess was suicidal and eventually developed more than 75 personalities, some of children, some of self-destructive sadists and some of men.
Just how she came to have those memories and beliefs will be decided over the next five weeks.
The familys argument
Hess attorneys William Smoler and Pamela Schmelzer said there is no question about MPD. It was a fad diagnosis in the 1980s and 1990s that has no medical support.
Satanic cults and ritual abuse, they said, are an urban myth. All reports of such behavior are the sole result of poor psychiatrists persuading patients to believe theyve been in cults.
Because there is no question that Hess believed in the cult, sexual abuse and other atrocities, there are only three possible explanations for her condition, Smoler said.
One, they could be true, and Joan and her family are really members of a baby-raping cult that pervaded Ladysmith, Wis., where she grew up, Smoler said.
Family members and friends will testify that there is no way that is possible, Smoler said.
Two, the memories could be false and Hess could be making it all up, trying to get attention and win millions of dollars in a lawsuit.
But even Fernandezs notes will show that Hess repeatedly said, This cant be true, this is not right, when she and Fernandez discussed the memories after hypnosis, Smoler said. Hess rejected the memories from the beginning and never wanted to believe them.
Then, there is the third possibility, Smoler said. That possibility is that these matters are false and that Dr. Fernandez is the one who implanted these memories in Joans mind.
As strange as that sounds, Smoler said, his expert witnesses will tell jurors that it is extremely easy to implant memories in someone who is under hypnosis and that patients can believe those memories with such vividness that they build a false life around them.
Even if jurors dont believe MPD is a hoax diagnosis, Smoler said, there is still no question that Fernandez was negligent in his treatment of Hess.
Fernandez never gathered the information he should have about Hesss background and prior medical conditions, Smoler said. He never researched the kind of therapy he was practicing and performed hypnosis with no training, he said.
Most importantly, Smoler said, Fernandez continued treating Hess with hypnosis and memory therapy even when her condition worsened to the point that she tried suicide several times.
The first oath a doctor takes, he said, is that above all else, he shall do no harm to his patients.
The defense argument
Defense attorneys Paul Grimstad and Thomas Rusboldt began refuting the Hess position with a primer on MPD, which they said has been a genuine illness recognized since the 1800s.
If a terrible series of events happens to a child, the child is powerless to control or understand them, Grimstad said. The child cant accept it, so the child uses imagination to say, Its not happening to me, its happening to someone else.
In doing so, Grimstad said, the mind creates a separate place in which it stores horrible memories and locks them away from consciousness. Those memories are the foundation of MPD.
MPD cases have multiplied in recent years, Grimstad said, not because a fad diagnosis swept through the psychiatric community, but because it became more acceptable to discuss childhood sexual abuse.
When adults started discussing those events, their hidden memories were released and MPD diagnoses multiplied, he said. Psychiatrists treat MPDs by trying to merge the different personalities back into one, functional unit.
Its easier said than done, Grimstad said, and treatment often takes many years with patients getting worse before they get better.
Such was the case with Hess, he said.
In fact, Grimstad said, Hesss problems began long before she began treatment with Fernandez. She first was hypnotized by Wausau therapist Carolyn Decker, whom Joan and John Hess began seeing in 1990 for Joans depression and their marital problems.
By the time Fernandez started seeing Joan Hess, Grimstad said, she already had memories of her father abusing her, already had been hospitalized for suicidal thoughts and already was having trouble with work.
It was during her hospitalization, Grimstad said, that the highly suggestible Hess might have received her ideas about satanic abuse. While there, he said, Hess met and befriended another MPD patient who recalled ritual abuse.
This may have been the genesis of the memories Mrs. Hess ultimately claimed as her own, Grimstad said.
Wherever she came by the ideas, it wasnt Fernandezs fault, Grimstad said. He said Fernandez used established and accepted medical techniques to treat Hess in the same way other doctors were treating MPD patients all over the country.
Often, all Dr. Fernandez could do was try to keep her alive and get her from one crisis to the next, he said.
Jurors heard their first testimony Wednesday from Joan Hess herself, who spent more than two hours relating her life from childhood to the time she started treatment with Decker.
Hess is expected to remain on the stand for two more days. Those two days will focus almost entirely on the time she was under Fernandezs care and her life after their sessions ended in 1994.
July 28, 1999
- Jury set to hear repressed memory lawsuit
Psychiatrist on trial for diagnosis
By Peter J. Wasson
Wausau Daily Herald
Opening arguments began this morning after two days of jury selection in the medical malpractice trial involving former Wausau Mayor John Hess and his family.
Hess and his ex-wife, Joan Hess, accuse Wausau psychiatrist Juan Fernandez III of destroying their lives by implanting memories of satanic and sexual abuse in Joan Hesss mind while she was hypnotized.
They are seeking unspecified monetary damages in the lawsuit, filed after Fernandez treated Joan Hess between 1993 and 1994.
The suit is the latest in a series of similar cases across the country in which the psychiatric diagnoses of multiple personality disorder and false memory syndrome have been debated.
The trial, scheduled to last five weeks, will revolve around Hess family allegations that Fernandez improperly used hypnotherapy and ended up persuading Joan Hess to believe that horrible things happened to her during her childhood.
Hess attorneys will have Washington state psychology professor Elizabeth Loftus, an outspoken critic of multiple personality diagnoses, testify as one of their leading witnesses.
Loftus already has testified as an expert witness in several similar trials and has written dozens of books and professional articles debunking multiple personalities and recovered memories.
Fernandez, whose lawyers have denied that he did anything inappropriate, will call psychiatric and memory experts to testify that multiple personality disorder and recovered memories are legitimate illnesses.
July 26, 1999
- Suits in memory cases on the rise
Hess trial begins today; publicity might bring Court TV to Wausau
By Peter J. Wasson and Nikki Kallio
Wausau Daily Herald
Joan Hess doesnt know what happened to her.
One day in 1993, she was a normal mother and nurse suffering from mild depression. A few months later, she claims, she was plagued by memories of her parents abusing her and forcing her to witness human sacrifices.
Hess blames Wausau psychiatrist Juan Fernandez III for destroying her life, and she is asking a Marathon County jury to settle a question that judges, juries and medical professionals havent been able to resolve for more than a decade.
The question: Are childhood memories of sexual abuse, satanic cults and other atrocities real, or have reckless psychiatrists implanted them in the minds of patients, destroying their lives?
Such cases, once rare, are much more common in psychiatrists offices. But as the repressed childhood memory diagnoses that multiplied in the 1980s have fallen out of favor in the 1990s, suits and even criminal charges have become even more common.
The suit filed by former Wausau mayor John Hess, his ex-wife Joan and their family against Fernandez will settle only a local debate, and only temporarily.
The anticipated five-week trial, which begins today, is just the latest in a string of lawsuits that began a decade ago and likely will continue as more patients accuse psychiatrists of negligence and malpractice.
Repressed memory cases have garnered so much attention in the media and medical community that national press and perhaps even Court TV are expected in Wausau to attend the trial.
In 1957, actress Joanne Woodward portrayed a troubled young woman diagnosed by her psychiatrist as having three separate personalities: A drab and boring housewife, a free-wheeling good time girl and a sophisticated, mature woman.
Woodwards performance in The Three Faces of Eve earned her a best actress Oscar and touched off an increase in patients complaining of multiple personalities and related disorders.
The movie was a first glimpse for most people into the life of a multiple personality, and it was unrealistic by todays standards. Woodwards character, Eve White, was easily helped by therapy and the root causes of her disorder were never fully explored.
It was a portent for the real-life cases to be explored in the 1980s and 1990s, many of which, like the Hess case, trace back to alleged traumatic childhood events.
The next multiple personality case to get widespread attention was that of Sybil. That book, and the 1976 movie version, was the beginning of the multiple personality debate that continues today.
Sybil was a young woman who went to Dr. Cornelia Wilbur in 1954 suffering from a variety of problems. Through counseling it was revealed that Sybil had a host of personalities, male and female, child and adult.
The personalities sprang forth after Wilbur used hypnosis, drugs and psychological techniques to draw them from within Sybils shattered psyche -- the same practices the Hess family accuses Fernandez of using.
Before the film version of Sybil, researchers say, there were fewer than 50 known cases of multiple personality disorder, or MPD. By 1990, more than 20,000 had been diagnosed, with estimates of as many as 2 million more.
The memory debate
Today, Sybil and her story have fallen into the controversy that surrounds MPD.
New York psychologist Robert Rieber recently published a report claiming Wilbur and Sybil author Flora Schreiber, overzealous to research and document a rare disease, implanted Sybils memories and personalities.
Unquestionably, Schreiber and Wilbur wanted to make Sybil a multiple personality no matter what, Rieber said in his report. Once the book became a financial success there was no turning back.
Whether Sybils problems were genuine or not, the repressed memory phenomenon began shortly after the film and exploded in the 1980s, when psychiatrists began diagnosing patients who came to them with relatively mild problems.
Some doctors said the mild problems were just a sign of much deeper-seated disorders. Often, those disorders sprang, they said, from a history of childhood sexual abuse.
Others said patients complaining of abuse really had no such memories, and that the real abuse was perpetrated by irresponsible psychiatrists.
Joan Hess, for example, went to Fernandez seeking help with nothing more serious than mild depression. She emerged from several months of therapy recalling her parents molesting her in a satanic cult when she was a child, according to court records.
The memories, the Hess family claims, were implanted by Fernandez while he had Joan under hypnosis.
Some in the mental health community say dismissing memories like Joans as false or implanted is simply another way of covering up sexual abuse. They say such memories are real and were repressed by the childs consciousness, only to be revealed later in life with a psychiatrists help.
Other mental health professionals, including the American Medical Association, have dismissed recovered memories as psychiatric hocus-pocus. There is no medical basis for believing such memories are real, they say.
Juries settle debate
With no single answer from the mental health community, victims and those they have accused have turned to the courts, just as the Hess family is now.
Two 1993 Twin Cities cases against St. Paul psychiatrist Diane Humenansky were among the first in the Midwest and included many of the same details of satanic cults and sexual abuse that the Hesses allege.
In fact, most of the publicized cases involving allegations of implanted memories are almost identical to the Hess case. According to research done in Washington state, almost all patients are middle-aged white women who had their first memories of abuse while in therapy.
Satanic ritual, group sex, bestiality and baby sacrifice are common in many of the multiple personality cases in which patients sue their therapists.
In general, juries have sided with patients and have awarded them anywhere from several thousand to several million dollars for their suffering.
The Hess family, according to Wisconsin law, cannot ask for a specific dollar amount in their suit. Their claims, if true, are similar to those of patients who have won millions in trials and settlements.
The Hess story
Joan Hess went to Fernandez in 1993, a year after her husband was first elected mayor, seeking treatment for depression as she prepared to return to her job as a nurse. Fernandez hypnotized her and, according to the Hesses, implanted memories in her mind while she was under hypnosis.
She was going to nursing school and working at the hospital and was just feeling a little stressed out with all the hours when she first went for help, John Hess said in a recent interview. I was shocked when she started coming home with these memories. It was unbelievable, the things I heard.
What Hess heard from his wife would have shocked most anyone. Joan Hess came to believe she was sexually abused by her parents, who were members of a cult that dressed in black robes and forced others to have sex with animals and witness human sacrifices, according to court records.
By the end of her treatment with Fernandez in 1994, Fernandez diagnosed Joan Hess as having at least 90 personalities, according to court records.
As a result, the Hess family was torn apart. The marriage between John and Joan failed, and Joan can no longer be a good mother to their children or hold a job, according to the suit.
Hess family attorney William Smoler, one of the most successful anti-MPD attorneys in the country, is expected to use some of the same witnesses he has used in other cases in his attempts to debunk multiple personality disorder and persuade jurors Fernandez was reckless and negligent.
He also will call memory experts and others with firsthand experience in MPD cases, some of them the same witnesses he used in 1997 for his landmark, $2.4-million Nadean Cool lawsuit in Appleton.
Fernandezs attorneys also will call medical and memory experts who will tell jurors memories are real and Fernandez brought them out of Joan Hess inner consciousness.
Neither side expects the Hess case to resolve the MPD dispute once and for all.
Its not a cut and dry issue, said Paul Fink, professor of psychology at Temple University School of Medicine and president of the Philadelphia-based Leadership Council, a group of psychologists, psychiatrists and lawyers concerned about motives behind lawsuits against therapists.
That makes it hard, he said. Theres also some bad therapists that make strong suggestions. Its a very complicated issue thats tried to be oversimplified with sound bytes.
About all that those on either side of the MPD issue can agree upon is that there needs to be much more research done in the memory field before abuses and the lawsuits that follow will end.
I think that suing a therapist is a counterproductive avenue because so many memories come back outside the therapists office for people, said Eileen King, executive director of the Washington, D.C.-based One Voice advocacy organization that is made up of survivors of sexual abuse, attorneys, mental health professionals and parents. I think we should be looking at the genesis of those memories -- not just in the therapists office but in other places. The public in general has no idea of the damage being done to the pursuit of therapy.
July 25, 1999
- Hess case illustrates repressed-memory debate
Former mayor, ex-wife suing her psychiatrist
By Peter J. Wasson and Nikki Kallio
Wausau Daily Herald
Doctors cant look at a repressed memory case and say for certain that, yes, repressed memory exists or no, it doesnt. Its not like looking at a broken arm and knowing its broken.
Repressed memory and multiple personality disorder, or MPD, in recent years have become the most hotly debated topics among psychiatric professionals.
The debate is so hot because of its nature: If MPD believers are right, there are thousands of child molesters out there who are going unrecognized and unpunished.
If MPD skeptics are right, mental health professionals are needlessly destroying the lives of the patients looking to them for help.
Former Wausau Mayor John Hess, his ex-wife Joan and their family are skeptics, and they say they can prove the devastating affects of false memories. The family is suing local psychiatrist Juan Fernandez III for allegedly implanting memories in Joans mind while she was under hypnosis.
Those memories eventually manifested themselves as multiple personalities -- more than 90 of them -- and tore the Hess family apart, leaving Joan unable to be a mother, wife or hold a job, according to the suit that goes to trial Monday.
This trial, its like reliving the whole thing again, John Hess said. Its very difficult for Joan, myself and our daughters. Its like reliving the whole episode, but its something we have to go through.
At the heart of the case is the question of whether Joan Hess really believes she was sexually assaulted as a child by members of a satanic cult or whether Fernandez persuaded her to accept that she was while under hypnosis.
Psychiatric patients everywhere have been asking themselves similar questions for years, and there are no clear-cut answers.
According to the Sidran Foundation, a support group for those who believe they suffer from MPD, the illness begins when a victim is a child and is faced with a tragedy from which they cannot escape.
The tragedy could be sexual abuse, physical trauma or something else so troubling that the child cannot bear it. Instead, the child may resort to going away in his or her head, according to a Sidran pamphlet on MPD.
This ability is typically used by children as an extremely effective defense against acute physical and emotional pain, or anxious anticipation of that pain, the pamphlet says. By this dissociative process, thoughts, feelings, memories, and perceptions of the traumatic experiences can be separated off psychologically, allowing the child to function as if the trauma had not occurred.
The defense works well for children, but becomes a disaster when it manifests itself later in an adults life.
Sometimes, those memories include satanic rituals and other extreme behavior. Its easy to get the impression that they all do, but thats because those cases get all the media attention.
The memories start leaking out of the adults consciousness, sometimes taking on other personalities and identities to express themselves.
Memories of satanic ritual abuse could be so common because theyre screened memories of another type of abuse, or they could be partially true, said Eileen King, executive director of the Washington, D.C.-based One Voice advocacy organization. One Voice is made up of survivors of sexual abuse, attorneys, mental health professionals and parents.
Its one of the most tantalizing questions around, King said. I really dont know anyone whos cracked that one.
One theory is that when things happen to someone in a developmental stage, the child might not be able to precisely remember what happened but images are translated in dreams.
That may be able to explain some of the more unusual elements that people remember, King said.
Skeptics are blaming the wrong people when they sue therapists, said Paul Fink, a psychology professor at Temple University and president of the Philadelphia-based Leadership Council, a group of psychologists, psychiatrists and lawyers.
An adult patient who remembers being sexually abused as a child finds it far easier to accuse a psychologist of malpractice than to accuse a parent of molesting the patient, he said.
I think that its very rare to implant false memories, Fink said. People do forget and can forget a traumatic memory and remember it. False memory people say its impossible and want to accuse the therapist rather than the perpetrator.
Some religious extremists even attribute MPD to satanic possession, claiming the personalities a patient exhibits are really the different guises of the devil speaking through the patients. Medical professionals dismiss that possibility.
Mental health experts, in recent years, have become far more likely to dismiss recovered/repressed memory diagnoses entirely. Just as diagnoses exploded in the 1970s and 1980s, journals, articles and studies rejecting MPD have exploded in recent years.
Elizabeth Loftus, a Seattle, Wash. psychology professor, has been one of the most outspoken MPD critics. She has testified in several trials, written dozens of books and articles and is scheduled to be an expert witness in the Hess trial.
She has compared the trend of MPD cases to a modern-day witch hunt.
Freud popularized the idea of repression, Loftus wrote in an e-mail message to the Wausau Daily Herald. But it was later, in the 80s that they became so fashionable in the sex abuse domain. There was already plenty of real abuse to focus on, but in the interests of making the numbers even more staggering, the therapist began to suggest that if you didnt report abuse it was because you didnt remember it yet. It became the explanation for all sorts of problems.
Loftus has been critical of her own profession, but she does not accuse mental health experts of setting out to destroy the lives of patients. Instead, she said, many counselors improperly trained in hypnosis and other therapies have inadvertently harmed patients.
People were using these suggestive techniques, thinking they were helping their patients and using suggestions with the best of intentions, Loftus said in a phone interview.
Civil and criminal cases exploded as spouses looked for reasons their marriages were failing, criminals sought rationalizations for their abuses and, in general, people looked to blame others for their problems.
Repressed/recovered memories were and are convenient, critics say, because they are impossible to prove or disprove.
Almost universally, the memories include allegations that parents, other family members, school counselors or the clergy molested children who later repressed those memories to protect themselves.
The very nature of the alleged crimes makes them almost impossible to verify; child molesters act in secret and arent likely to confess 20 or 30 years after their crimes. No one, even the adult remembering the abuse, really knows what happened.
In one Washington state case, the accused abuser began recalling instances in which he involved his daughter in group sex, bestiality and satanism, and maintained those memories even after it was proven that some of those events could never have happened.
Criminal court records themselves refute MPD. If, as victims allege, there are satanic cults killing and eating babies all over the country, where are the bodies? Why are cult members never revealed and prosecuted? How can so many people be doing so many terrible things to children and never get caught?
Terence Campbell, a Michigan clinical psychologist and member of the Professional and Scientific Advisory Board of the False Memory Syndrome Foundation, said the FBI and other police agencies in the late 1980s and early 1990s searched high and low for physical evidence for satanic cults.
They found nothing, Campbell said.
Counselors who diagnose MPD and find evidence of satanic cults, bestiality and other extreme behavior do so for a reason, Campbell said.
Those outcomes correspond to expectations of therapists who frequently have mistreated their clients, he said. Thats what therapists expected to find.
Psychiatric professionals themselves can offer no definitive answers about recovered or repressed memories.
Depends on what you mean by repression, Loftus wrote in an e-mail message. That we banish streams of brutalization out of conscious awareness, that they leak and cause us to do destructive things, that we can reliably recover these with certain techniques -- no credible scientific support!
In the end, patients struggling with memories, failing marriages, lost jobs and other ramifications turn to the courts for answers, as the Hesses are.
Even the American Medical Association has not been able to give its members or their patients a clear answer.
Overall, according to one of its publications, the AMA recognizes that few cases in which adults make accusations of childhood sexual abuse based on recovered memories can be proved or disproved and it is not yet known how to distinguish true memories from imagined events in these cases.