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Satanic ritual abuse (SRA, sometimes known as ritual abuse, ritualistic abuse, organised abuse, sadistic ritual abuse, and other variants) was the subject of a moral panic that originated in the United States in the 1980s, spreading throughout the country and eventually to many parts of the world by the late 1990s. Allegations of SRA involved reports of physical and sexual abuse of people in the context of occult or Satanic rituals. In its most extreme form, SRA involves a worldwide organisation including the wealthy and powerful of the world elite in which children are abducted or bred for sacrifices, pornography and prostitution.

Nearly every aspect of SRA was controversial, including its definition, the source of the allegations and proof thereof, testimonials of alleged victims, and court cases involving the allegations and criminal investigations. The panic affected lawyers', therapists', and social workers' handling of allegations of child sexual abuse. Allegations initially brought together widely dissimilar groups, including religious fundamentalists, police investigators, child advocates, therapists, and clients in psychotherapy. The movement gradually secularized, dropping or deprecating the "satanic" aspects of the allegations in favor of names that were less overtly religious such as "sadistic" or simply "ritual abuse" and becoming more associated with dissociative identity disorder and anti-government conspiracy theories.

Initial publicity came via the book Michelle Remembers (1980), and was sustained and popularized throughout the decade by the McMartin preschool trial. Testimonials, symptom lists, rumors, and techniques to investigate or uncover memories of SRA were disseminated through professional, popular, and religious conferences, as well as through the attention of talk shows, sustaining and further spreading the moral panic throughout the United States and beyond. In some cases, allegations resulted in criminal trials with varying results; after seven years in court, the McMartin trial resulted in no convictions for any of the accused, while other cases resulted in lengthy sentences, some of which were later reversed. Scholarly interest in the topic slowly built, eventually resulting in the conclusion that the phenomenon was a moral panic, which, as Sarah Hughes observed in 2017, "involved hundreds of accusations that devil-worshipping paedophiles were operating America's white middle-class suburban daycare centers."

Official investigations produced no evidence of widespread conspiracies or of the slaughter of thousands; only a small number of verified crimes have even remote similarities to tales of SRA. In the latter half of the 1990s, interest in SRA declined and skepticism became the default position, with very few researchers giving any credence to the existence of SRA.

Historical precedents


The SRA panic repeated many of the features of historical moral panics and conspiracy theories, such as the blood libel against Jews by Apion in the 30s CE, the wild rumors that led to the persecutions of early Christians in the Roman Empire, later allegations of Jewish rituals involving the killing of Christian babies and desecration of the Eucharist, and the witch hunts of the 16th and 17th centuries. Allegations of horrific acts by outsider groups—including cannibalism, child murder, torture and incestuous orgies—may have served as a form of "othering" for minority groups, as well scapegoat explanations for complex problems in times of social disruption. Torture and imprisonment were used by authority figures to coerce confessions from alleged Satanists, confessions that were later used to justify their execution. Records of these older allegations were linked by contemporary proponents in an effort to demonstrate the contemporary Satanic cults were part of an ancient conspiracy of evil, though ultimately there is no evidence for devil-worshipping cults in Europe at any time. A more immediate precedent to the context of the United States was McCarthyism in the 1950s.

The underpinnings for the contemporary moral panic were found in a rise of five factors in the years leading up to the 1980s: the establishment of fundamentalist Christianity and political organization of the Moral Majority; the rise of the Anti-cult movement which spread ideas of abusive cults kidnapping and brainwashing children and teens; the appearance of the Church of Satan and other explicitly Satanist groups that added a kernel of truth to the existence of Satanic cults; the development of the social work or child protection field, and its struggle to have child sexual abuse recognized as a social problem and a serious crime; and the popularization of posttraumatic stress disorder, repressed memory, and corresponding survivor movement.

Michelle Remembers and the McMartin preschool trial
Michelle Remembers, written by Michelle Smith and her husband, the psychiatrist Lawrence Pazder, was published in 1980. Now discredited, the book was written in the form of an autobiography, presenting the first modern claim that child abuse was linked to Satanic rituals. Pazder was also responsible for coining the term "ritual abuse." Michelle Remembers provided a model for numerous allegations of SRA that ensued later in the same decade. On the basis of the book's success, Pazder developed a high media profile, gave lectures and training on SRA to law enforcement, and by September 1990 had acted as a consultant on more than 1,000 SRA cases, including the McMartin preschool trial. Prosecutors used Michelle Remembers as a guide when preparing cases against alleged Satanists. Michelle Remembers, along with other accounts portrayed as survivor stories, are suspected to have influenced later allegations of SRA, and the book has been suggested as a causal factor in the later epidemic of SRA allegations.

The early 1980s, during the implementation of mandatory reporting laws, saw a large increase in child protection investigations in America, Britain, and other developed countries, along with a heightened public awareness of child abuse. The investigation of incest allegations in California was also changed, with cases led by social workers who used leading and coercive interviewing techniques that had been avoided by police investigators. Such changes in the prosecution of cases of alleged incest resulted in an increase in confessions by fathers in exchange for plea bargains. Shortly thereafter, some children in child protection cases began making allegations of horrific physical and sexual abuse by caregivers within organized rituals, claiming sexual abuse in Satanic rituals and the use of Satanic symbols. These cases garnered the label "satanic ritual abuse" both in the media and among professionals. Childhood memories of similar abuse began to appear in the psychotherapy sessions of adults.

In 1983, charges were laid in the McMartin preschool trial, a major case in California, which received attention throughout the United States and contained allegations of satanic ritual abuse. The case caused tremendous polarization in how to interpret the available evidence. Shortly afterward, more than 100 preschools across the country became the object of similar sensationalist allegations, which were eagerly and uncritically reported by the press. Throughout the McMartin trial, media coverage of the defendants (Peggy McMartin and Ray Buckey) was unrelentingly negative, focusing only on statements by the prosecution. Michelle Smith and other alleged survivors met with parents involved in the trial, and it is believed that they influenced testimony against the accused.

Kee MacFarlane, a social worker employed by the Children's Institute International, developed a new way to interrogate children with anatomically correct dolls and used them in an effort to assist disclosures of abuse with the McMartin children. After asking the children to point to the places on the dolls where they had allegedly been touched and asking leading questions, MacFarlane diagnosed sexual abuse in virtually all the McMartin children. She coerced disclosures by using lengthy interviews that rewarded discussions of abuse and punished denials. The trial testimony that resulted from such methods was often contradictory and vague on all details except for the assertion that the abuse had occurred. Although the initial charges in the McMartin case featured allegations of Satanic abuse and a vast conspiracy, these features were dropped relatively early in the trial, and prosecution continued only for non-ritual allegations of child abuse against only two defendants. After three years of testimony, McMartin and Buckey were acquitted on 52 of 65 counts, and the jury was deadlocked on the remaining 13 charges against Buckey, with 11 of 13 jurors choosing not guilty. Buckey was re-charged and two years later released without conviction.

Conspiracy accusations
In 1984 MacFarlane warned a congressional committee of scatological behavior and animals being slaughtered in bizarre rituals that children were forced to watch. Shortly after, the United States Congress doubled its budget for child-protection programs. Psychiatrist Roland Summit delivered conferences in the wake of the McMartin trial and depicted the phenomenon as a conspiracy that involved anyone skeptical of the phenomenon. By 1986, social worker Carol Darling argued to a grand jury that the conspiracy reached the government. Her husband Brad Darling gave conference presentations about a Satanic conspiracy of great antiquity which he believed now permeated American communities.

By the late 1980s, therapists or patients who believed someone had suffered from SRA could suggest solutions that included Christian psychotherapy, exorcism, and support groups whose members self-identified as "anti-Satanic warriors." Federal funding was increased for research on child abuse, with large portions of the funding allocated for research on child sexual abuse. Funding was also provided for conferences supporting the idea of SRA, adding a veneer of respectability to the idea as well as offering an opportunity for prosecutors to exchange advice on how to best secure convictions—with tactics including destruction of notes, refusing to tape interviews with children, and destroying or refusing to share evidence with the defense. Had proof been found, SRA would have represented the first occasion where an organized and secret criminal activity had been discovered by mental health professionals. In 1987 Geraldo Rivera produced a national television special on the alleged secret cults, claiming "Estimates are that there are over one million Satanists in [the United States and they are] linked in a highly organized, secretive network." Tapings of this and similar talk show episodes were subsequently used by religious fundamentalists, psychotherapists, social workers and police to promote the idea that a conspiracy of Satanic cults existed and was committing serious crimes.

In the 1990s psychologist D. Corydon Hammond publicized a detailed theory of ritual abuse drawn from hypnotherapy sessions with his patients, alleging they were victims of a worldwide conspiracy of organized, secretive clandestine cells who used torture, mind control and ritual abuse to create alternate personalities that could be "activated" with code words; the victims were allegedly trained as assassins, prostitutes, drug traffickers, and child sex workers (to create child pornography). Hammond claimed his patients had revealed the conspiracy was masterminded by a Jewish doctor in Nazi Germany, but who now worked for the Central Intelligence Agency with a goal of worldwide domination by a Satanic cult. The cult was allegedly composed of respectable, powerful members of society who used the funds generated to further their agenda. Missing memories among the victims and absence of evidence was cited as evidence of the power and effectiveness of this cult in furthering its agenda. Hammond's claims gained considerable attention, due in part to his prominence in the field of hypnosis and psychotherapy.

Religious roots and secularization
Satanic ritual abuse brought together several groups normally unlikely to associate, including psychotherapists, self-help groups, religious fundamentalists and law enforcement. Initial accusations were made in the context of the rising political power of conservative Christianity within the United States, and religious fundamentalists enthusiastically promoted rumors of SRA. Psychotherapists who were actively Christian advocated for the diagnosis of dissociative identity disorder (DID); soon after, accounts similar to Michelle Remembers began to appear, with some therapists believing the alter egos of some patients were the result of demonic possession. Protestantism was instrumental in starting, spreading, and maintaining rumors through sermons about the dangers of SRA, lectures by purported experts, and prayer sessions, including showings of the 1987 Geraldo Rivera television special. Secular proponents appeared, and child protection workers became significantly involved. Law enforcement trainers, many themselves strongly religious, became strong promoters of the claims and self-described "experts" on the topic. Their involvement in child sexual abuse cases produced more allegations of SRA, adding credibility to the phenomenon. As the explanations for SRA were distanced from evangelical Christianity and associated with "survivor" groups, the motivations ascribed to purported Satanists shifted from combating a religious nemesis, to mind control and abuse as an end to itself. Clinicians, psychotherapists and social workers documented clients with alleged histories of SRA, though the claims of therapists were unsubstantiated beyond the testimonies of their clients.

International spread
In 1987 a list of "indicators" was published by Catherine Gould, featuring a broad array of vague symptoms that were ultimately common, non-specific and subjective, capable of diagnosing SRA in most young children. By the late 1980s allegations began to appear throughout the world (including Canada, Australia, the United Kingdom, New Zealand, the Netherlands and Scandinavia), in part enabled by English as a common international language and in the United Kingdom, assisted by Gould's list of indicators. Belief in SRA spread rapidly through the ranks of mental health professionals (despite an absence of evidence) through a variety of continuing education seminars, during which attendees were urged to believe in the reality of Satanic cults their victims, and not to question the extreme and bizarre memories uncovered. Proof was provided in the form of unconnected bits of information such as pictures drawn by patients, heavy metal album covers, historical folklore about devil worshipers, and pictures of mutilated animals. During the seminars, patients provided testimonials of their experiences and presenters stressed that recovering memories was important for healing.
 * In 1986, the largest symposium on child abuse in history was held in Australia, with addresses by vocal SRA advocates Kee MacFarlane, Roland Summit, Astrid Heppenstall Heger, and David Finkelhor.
 * In 1987, writings on the phenomenon appeared in the United Kingdom along with incidents featuring broadly similar accusations such as the Cleveland child abuse scandal; allegations of SRA in Nottingham resulted in the "British McMartin", advised in part by the British journalist Tim Tate's work on the subject. Along with the list of indicators, American conference speakers, pamphlets, source materials, consultants, vocabulary regarding SRA and allegedly funding were imported, which promoted the identification and counseling of British SRA allegations. The Nottingham investigation resulted in criminal charges of severe child abuse that ultimately had nothing to do with Satanic rituals, and was criticized for focusing on the irrelevant and non-existent Satanic aspects of the allegations at the expense of the severe conventional abuse endured by the children.
 * In 1989, San Francisco police detective Sandi Gallant gave an interview with a newspaper in the United Kingdom. At the same time, several other therapists toured the country giving talks on SRA, and shortly thereafter SRA cases occurred in Orkney, Rochdale, London and Nottingham.
 * In 1992 charges were laid in the Martensville satanic sex scandal; charges were overturned in 1995 on the grounds of improper interviewing of the children.
 * A wave of SRA accusations appeared in New Zealand in 1991, and in Norway in 1992.
 * In 1998 Jean LaFontaine produced a book indicating allegations of SRA in the United Kingdom were sparked by investigations supervised by social workers who had taken SRA seminars in the United States.

Skepticism, rejection and contemporary existence
Media coverage of SRA began to turn negative by 1987, and the "panic" ended between 1992 and 1995. The release of the HBO made-for-TV movie Indictment: The McMartin Trial in 1995 re-cast Ray Buckey as a victim of overzealous prosecution rather than an abusive predator and marked a watershed change in public perceptions of satanic ritual abuse accusations. By 2003 allegations of ritual abuse were met with great skepticism and belief in SRA was no longer considered mainstream in professional circles; although the sexual abuse of children is a real and serious problem, allegations of SRA were essentially false. Reasons for the collapse of the phenomenon include the collapse of criminal prosecution against alleged abusers, a growing number of scholars, officials and reporters questioning the reality of the accusations, and a variety of successful lawsuits against mental health professionals. Astrophysicist and astrobiologist Carl Sagan devoted an entire chapter of his last book, The Demon-Haunted World: Science as a Candle in the Dark (1996) to a critique of claims of recovered memories of UFO abductions and satanic ritual abuse and cited material from the newsletter of the False Memory Syndrome Foundation with approval.

Some feminist critics of the SRA diagnoses maintained that, in the course of attempting to purge society of evil, the panic of the 1980s and 1990s obscured real child-abuse issues, a concern echoed by Gary Clapton. In England, the SRA panic diverted resources and attention from proven abuse cases; this resulted in a hierarchy of abuse in which SRA was the most serious form, physical and sexual abuse being minimized and/or marginalized, and "mere" physical abuse no longer worthy of intervention. In addition, as criticism of SRA investigation increased, the focus by social workers on SRA resulted in a large loss of credibility to the profession. SRA, with its sensational makeup of many victims abused by many victimizers, ended up robbing the far more common and proven issue of incest of much of its societal significance. The National Center for Abuse and Neglect devised the term "religious abuse" to describe exorcism, poisoning, and drowning of children in non-satanic religious settings in order to avoid confusion with SRA.

A small number of people still believe there is credence to allegations of SRA and continue to discuss the topic. Publications by Cathy O'Brien claiming SRA were the result of government programs (specifically the Central Intelligence Agency's Project MKULTRA) to produce Manchurian candidate-style mind control in young children were picked up by conspiracy theorists, linking belief in SRA with claims of government conspiracies. In the book Mistakes Were Made (But Not by Me), authors Carol Tavris and Elliot Aronson cite ongoing belief in the SRA phenomenon despite a complete lack of evidence as demonstration of the confirmation bias in believers; it further points out that a lack of evidence is actually considered by believers in SRA as more evidence, demonstrating "how clever and evil the cult leaders were: They were eating those babies, bones and all."

Definitions
The term "satanic ritual abuse" is used to describe different behaviors, actions and allegations that lie between extremes of definitions. In 1988, a nationwide study of sexual abuse in U.S. day care agencies, led by David Finkelhor, divided "ritual abuse" allegations into three categories—cult-based ritualism in which the abuse had a spiritual or social goal for the perpetrators, pseudo-ritualism in which the goal was sexual gratification and the rituals were used to frighten or intimidate victims, and psychopathological ritualism in which the rituals were due to mental disorders. Subsequent investigators have expanded on these definitions and also pointed to a fourth alleged type of Satanic ritual abuse, in which petty crimes with ambiguous meaning (such as graffiti or vandalism) generally committed by teenagers were attributed to the actions of Satanic cults.

By the early 1990s, the phrase "Satanic ritual abuse" was featured in media coverage of ritualistic abuse but its use decreased among professionals in favour of more nuanced terms such as multi-dimensional child sex rings, ritual/ritualistic abuse, organised abuse or sadistic abuse, some of which acknowledged the complexity of abuse cases with multiple perpetrators and victims without projecting a religious framework onto perpetrators. The latter in particular failed to substantively improve on or replace "Satanic" abuse as it was never used to describe any rituals except the Satanic ones that were the core of SRA allegations. Abuse within the context of Christianity, Islam or any other religions failed to enter the SRA discourse.

Cult-based abuse
Allegation of cult-based abuse is the most extreme scenario of SRA. During the initial period of interest starting in the early 1980s the term was used to describe a network of Satan-worshipping, secretive intergenerational cults that were supposedly part of a highly organized conspiracy engaged in criminal behaviors such as forced prostitution, drug distribution and pornography. These cults were also thought to sexually abuse and torture children in order to coerce them into a lifetime of Devil worship. Other allegations included bizarre sexual acts such as necrophilia, forced ingestion of semen, blood and feces, cannibalism, orgies, liturgical parody such as pseudosacramental use of feces and urine; infanticide, sacrificial abortions to eat fetuses and human sacrifice; satanic police officers who covered up evidence of SRA crimes and desecration of Christian graves. No evidence of any of these claims has ever been found;  the proof presented by those who alleged the reality of cult-based abuse primarily consisted of the memories of adults recalling childhood abuse, the testimony of young children and extremely controversial confessions. The idea of a murderous Satanic conspiracy created a controversy dividing the professional child abuse community at the time, though no evidence has been found to support allegations of a large number of children being killed or abused in Satanic rituals. From a law enforcement perspective, an intergenerational conspiracy dedicated to ritual sacrifice whose members remain completely silent, make no mistakes and leave no physical evidence is unlikely; cases of what the media incorrectly perceived as actual cult sacrifices (such as the 1989 case of Adolfo Constanzo) have supported this idea.

Pseudo-satanism
Satanic ritual abuse is also used to describe the actions of "pseudo-satanists" who sexually abuse children and use the trappings of satanic rituals and claims of magical powers to coerce and terrify victims, but do not actually believe in the rituals. A survey of more than 12,000 SRA allegations, which found no substantiating evidence for an intergenerational conspiracy, did document several examples of abuse by pseudo-satanists.

Criminal and delusional satanism
A third variation of ritual abuse involves non-religious ritual abuse in which the rituals were delusional or obsessive. There are incidents of extreme sadistic crimes that are committed by individuals, loosely organized families and possibly in some organized cults, some of which may be connected to Satanism, though this is more likely to be related to sex trafficking; though SRA may happen in families, extended families and localized groups, it is not believed to occur in large, organized groups.

Acting out
Investigators considered graffiti such as the pentagram to be evidence of a Satanic cult. Ambiguous crimes in which actual or erroneously believed symbols of Satanism appear have also been claimed as part of the SRA phenomenon, though in most cases the crimes cannot be linked to a specific belief system; minor crimes such as vandalism, trespassing and graffiti were often found to be the actions of teenagers who were acting out.

Polarization
There was never any consensus on what actually constituted Satanic ritual abuse. This lack of a single definition, as well as confusion between the meanings of the term "ritual" (religious versus psychological) allowed a wide range of allegations and evidence to be claimed as a demonstration of the reality of SRA claims, irrespective of which "definition" the evidence supported. Acrimonious disagreements between groups who supported SRA allegations as authentic and those criticizing them as unsubstantiated resulted in an extremely polarized discussion with little middle ground. The lack of credible evidence for the more extreme interpretations often being seen as evidence of an effective conspiracy rather than an indication that the allegations are unfounded. The atheistic or religious beliefs of the disputants have also resulted in different interpretations of evidence, and as well as accusations of those who reject the claims being "anti-child". Both believers and skeptics have developed networks to disseminate information on their respective positions. One of the central themes of the discussion among English child abuse professionals was the assertion that people should simply "believe the children", and that the testimony of children was sufficient proof, which ignored the fact that in many cases the testimony of children was interpreted by professionals rather than the children explicitly disclosing allegations of abuse. In some cases this was simultaneously presented with the idea that it did not matter if SRA actually existed, that the empirical truth of SRA was irrelevant, that the testimony of children was more important than that of doctors, social workers and the criminal justice system.

Evidence
The evidence for SRA was primarily in the form of testimonies from children who made allegations of SRA, and adults who claim to remember abuse during childhood, that may have been forgotten and recovered during therapy. With both children and adults, no corroborating evidence has been found for anything except pseudosatanism in which the satanic and ritual aspects were secondary to and used as a cover for sexual abuse. Despite this lack of objective evidence, and aided by the competing definitions of what SRA actually was, proponents claimed SRA was a real phenomenon throughout the peak and during the decline of the moral panic. Despite allegations appearing in the United States, Netherlands, Sweden, New Zealand and Australia, no material evidence has been found to corroborate allegations of organized cult-based abuse that practices human sacrifice and cannibalism. Though trauma specialists frequently claimed the allegations made by children and adults were the same, in reality the statements made by adults were more elaborate, severe, and featured more bizarre abuse. In 95% of the adults' cases, the memories of the abuse were recovered during psychotherapy.

For several years, a conviction list assembled by the Believe the Children advocacy group was circulated as proof of the truth of satanic ritual abuse allegations, though the organization itself no longer exists and the list itself is "egregiously out of date".

Investigations
Two investigations were carried out to assess the evidence for SRA. In the United States, evidence was reported but was based on a flawed methodology with an overly liberal definition of a substantiated case. In the United Kingdom, a government report produced no evidence of SRA, but several examples of false satanists faking rituals to frighten their victims.

United States
David Finkelhor completed an investigation of child sexual abuse in daycares in the United States, and published a report in 1988. The report found 270 cases of sexual abuse, of which 36 were classified as substantiated cases of ritual abuse. Mary de Young has pointed out that the report's definition of "substantiated" was overly liberal as it required only that one agency had decided that abuse had occurred, even if no action was taken, no arrests made, no operating licenses suspended. In addition, multiple agencies may have been involved in each case (including the FBI, local police, social services agencies and childhood protective services in many cases), with wide differences in suspicion and confirmation, often in disagreement with each other. Finkelhor, upon receiving a "confirmation", would collect information from whoever was willing or interested to provide it and did not independently investigate the cases, resulting in frequent errors in their conclusions. No data is provided beyond case studies and brief summaries. Three other cases considered corroborating by the public—the McMartin preschool trial, the Country Walk case and the murders in Matamoros, by Adolfo Constanzo—ultimately failed to support the existence of SRA. The primary witness in the Country Walk case repeatedly made, then withdrew accusations against her husband amid unusual and coercive inquiries by her lawyer and a psychologist. The Matamoros murders produced the bodies of 12 adults who were ritually sacrificed by a drug gang inspired by the film The Believers, but did not involve children or sexual abuse. The McMartin case resulted in no convictions and was ultimately based on accusations by children with no proof beyond their coerced testimonies. A 1996 investigation of more than 12,000 allegations of satanic, ritual and religious abuse resulted in no cases that were considered factual or corroborated.

United Kingdom
A British study published in 1996 found 62 cases of alleged ritual abuse reported to researchers by police, social and welfare agencies from the period of 1988 to 1991, representing a tiny proportion of extremely high-profile cases compared to the total number investigated by the agencies. Anthropologist Jean LaFontaine spent several years researching ritual abuse cases in Britain at the behest of the government, finding that all of the cases of alleged satanic ritual abuse that could be substantiated were cases where the perpetrators' goal was sexual gratification rather than religious worship. Producing several reports and the 1998 book Speak of the Devil, after reviewing cases reported to police and children's protective services throughout the country LaFontaine concluded that the only rituals she uncovered were those invented by child abusers to frighten their victims or justify the sexual abuse. In addition, the sexual abuse occurred outside of the rituals, indicating the goal of the abuser was sexual gratification rather than ritualistic or religious. In cases involving satanic abuse, the satanic allegations by younger children were influenced by adults, and the concerns over the satanic aspects were found to be compelling due to cultural attraction of the concept, but distracting from the actual harm caused to the abuse victims.

In more recent years, discredited allegations of SRA have been levelled against Jimmy Saville during the posthumous investigation into his sexual abuse of children, as well as against former Prime Minister Ted Heath (who was previously falsely accused of SRA within his lifetime).

Patient allegations
The majority of adult testimonials occurred as a result of adults undergoing psychotherapy, in most cases therapy designed to elicit memories of SRA. Therapists claimed the pain expressed by the patients, internal consistency of their stories and similarity of allegations by different patients was evidence for SRA, but despite this, the disclosures of patients never resulted in any corroboration; Allegations of alleged victims that were obtained from mental health practitioners lacked verifiable evidence, were anecdotal and involved incidents that were years or decades old. The concern for therapists revolved around the pain of their clients, which is for them more important than the truth of their patients' statements. A sample of 29 patients in a medical clinic reporting SRA found no corroboration of the claims in medical records or in discussion with family members. and a survey of 2,709 American therapists found the majority of allegations of SRA came from only sixteen therapists, suggesting that the determining factor in a patient making allegations of SRA was the therapist's predisposition. Further, the alleged similarities between patient accounts (particularly between adults and children) turned out to be illusory upon review, with adults describing far more elaborate, severe and bizarre abuse than children. Bette Bottoms, who reviewed hundreds of claims of adult and child abuse, described the ultimate evidence for the abuse as "astonishingly weak and ambiguous" particularly given the severity of the alleged abuse. Therapists however, were found to believe patients more as the allegations became more bizarre and severe.

In cases where patients made claims that were physically impossible, or evidence found by police was contradictory, the details reported will often change. If patients pointed to a spot where a body was buried, but no body was found and no earth was disturbed, therapists resort to special pleading, saying the patient was hypnotically programmed to direct investigators to the wrong location, or that they were fooled by the cult into believing a crime was not committed. If alleged bodies were cremated and police point out ordinary fires are inadequate to completely destroy a body, stories include special industrial furnaces. The patients' allegations change and creatively find "solutions" to objections.

Children's allegations
The second group to make allegations of SRA were young children. During the "satanic panic" of the 1980s, the techniques used by investigators to gather evidence from witnesses, particularly young children, evolved to become very leading, coercive and suggestive, pressuring young children to provide testimony and refusing to accept denials while offering inducements that encouraged false disclosures. The interviewing techniques used were the factors believed to have led to the construction of the bizarre disclosures of SRA by the children and changes to forensic and interviewing techniques since that time has resulted in a disappearance of the allegations. Analysis of the techniques used in two key cases (the McMartin preschool and Wee Care Nursery School trials) concluded that the children were questioned in a highly suggestive manner. Compared with a set of interviews from Child Protective Services, the interviews from the two trials were "significantly more likely to (a) introduce new suggestive information into the interview, (b) provide praise, promises, and positive reinforcement, (c) express disapproval, disbelief, or disagreement with children, (d) exert conformity pressure, and (e) invite children to pretend or speculate about supposed events."

Specific allegations from the cases included:
 * Seeing witches fly; travel in a hot air balloon; abuse and travel through underground tunnels; identifying actor Chuck Norris from a series of pictures as an abuser; orgies at car washes and airports, children being flushed down toilets to secret rooms where they would be abused, then cleaned up and presented back to their unsuspecting parents (McMartin preschool trial, no forensic evidence was found to support these claims)
 * Being raped with knives (including a 12-inch blade ), sticks, forks, and magic wands; assault by a clown in a magic room; being forced to drink urine; tied naked to a tree (Fells Acres Day Care Center preschool trial; no forensic evidence was found to support these claims)
 * Ritual murder of babies; children taken out on boats and thrown overboard; trips in hot air balloons; babies were thrown against walls; children were penetrated with knives and forks; the walls and floors of the center's music room were spread with urine and feces (Little Rascals day care sexual abuse trial; no forensic evidence was found to support these claims)
 * Forced to act in child pornography and used for child prostitution; tortured; made to watch snuff films (Kern County child abuse cases; no child pornography was ever found to substantiate these accusations)
 * the mentally handicapped abuser who suffered from Noonan syndrome drank human blood in satanic rituals; abducted the children despite being unable to drive; forced the children to eat urine and feces; abducted the children to secret rooms; committed violent sexual assaults and beatings; killed a giraffe, rabbit and elephant and drank their blood in front of the children; (Faith Chapel Church ritual abuse case; no forensic evidence was found to support these claims)

A variety of these allegations resulted in criminal convictions; in an analysis of these cases Mary de Young found that many had had their convictions overturned. Of 22 day care employees and their sentences reviewed in 2007, three were still incarcerated, eleven had charges dismissed or overturned, and eight were released before serving their full sentences. Grounds included technical dismissals, constitutional challenges and prosecutorial misconduct.

As a moral panic
SRA has been called a moral panic and compared to the blood libel and witch-hunts of historical Europe,  and McCarthyism in the United States during the 20th century. Stanley Cohen, who originated the term "moral panic," called the episode "one of the purest cases of moral panic." The initial investigations of SRA were performed by anthropologists and sociologists, who failed to find evidence of SRA actually occurring; instead they concluded that SRA was a result of rumors and folk legends that were spread by "media hype, Christian fundamentalism, mental health and law enforcement professionals and child abuse advocates." Sociologists and journalists noted the vigorous nature with which some evangelical activists and groups were using claims of SRA to further their religious and political goals. Other commentators suggested that the entire phenomenon may be evidence of a moral panic over Satanism and child abuse. Skeptical explanations for allegations of SRA have included an attempt by radical feminists to undermine the nuclear family, a backlash against working women, homophobic attacks on gay childcare workers, a universal need to believe in evil, fear of alternative spiritualities, "end of the millennium" anxieties, or a transient form of temporal lobe epilepsy.

Jeffrey Victor says that in the United States the groups most likely to believe rumors of SRA are rural, poorly educated religiously conservative Protestant blue-collar families with an unquestioning belief in American values who feel significant anxieties over job loss, economic decline and family disintegration. Victor considers rumours of SRA a symptom of a moral crisis and form of scapegoating for economic and social ills.

Origins of the rumors
Information about SRA claims spread through conferences presented to religious groups, churches and professionals such as police forces and therapists as well as parents. These conferences and presentations served to organize agencies and foster communication between groups, maintaining and spreading disproven or exaggerated stories as fact. Members of local police forces organized into loose networks focused on cult crimes, some of whom billed themselves as "experts" and were paid to speak at conferences throughout the United States. Religious revivalists also took advantage of the rumors and preached about the dangers of Satanism to youth and presented themselves at paid engagements as secular experts. At the height of the panic, the highly emotional accusations and circumstances of SRA allegations made it difficult to investigate the claims, with the accused being assumed as guilty and skeptics becoming co-accused during trials, and trials moving forward based solely on the testimony of very young children without corroborating evidence. No forensic or corroborating evidence has ever been found for religiously based cannibalistic or murderous SRA, despite extensive investigations. The concern and reaction expressed by various groups regarding the seriousness or threat of SRA has been considered out of proportion to the actual threat by satanically motivated crimes, and the rare crime that exists that may be labeled "satanic" does not justify the existence of a conspiracy or network of religiously motivated child abusers. Blake Smith points out that in the wake of rising interest in satanism in pop culture the public interest in this topic can be summarized as follows: "Satan was a staple talk-show topic throughout the period, and very little critical response to such coverage was promoted because many people found it entertaining even if they didn't believe what was being said. "

Scholarly and law enforcement investigations
Jeffrey Victor reviewed 67 rumors about SRA in the United States and Canada reported in newspapers or television, and found no evidence supporting the existence of murderous satanic cults. LaFontaine states that cases of alleged SRA investigated in the United Kingdom were reviewed in detail and the majority were unsubstantiated; three were found to involve sexual abuse of children in the context of rituals, but none involved the Witches' Sabbath or devil-worship that are characteristic of allegations of SRA. LaFontaine also states that no material evidence has been forthcoming in allegations of SRA, no bones, bodies or blood, in either the United States or Britain.

Kenneth Lanning, an FBI expert in the investigation of child sexual abuse, has stated that pseudo-satanism may exist but there is "little or no evidence for ... large-scale baby breeding, human sacrifice, and organized satanic conspiracies". "There are many possible alternative answers to the question of why victims are alleging things that don't seem to be true....I believe that there is a middle ground—a continuum of possible activity. Some of what the victims allege may be true and accurate, some may be misperceived or distorted, some may be screened or symbolic, and some may be 'contaminated' or false. The problem and challenge, especially for law enforcement, is to determine which is which. This can only be done through active investigation. I believe that the majority of victims alleging 'ritual' abuse are in fact victims of some form of abuse or trauma."

Lanning produced a monograph in 1994 on SRA aimed at child protection authorities, which contained his opinion that despite hundreds of investigations no corroboration of SRA had been found. Following this report, several convictions based on SRA allegations were overturned and the defendants released.

Reported cases of SRA involve bizarre activities, some of which are impossible (like people flying), that makes the credibility of victims of child sexual abuse questionable. In cases where SRA is alleged to occur, Lanning describes common dynamics of the use of fear to control multiple young victims, the presence of multiple perpetrators and strange or ritualized behaviors, though allegations of crimes such as human sacrifice and cannibalism do not seem to be true. Lanning also suggests several reasons why adult victims may make allegations of SRA, including "pathological distortion, traumatic memory, normal childhood fears and fantasies, misperception, and confusion".

Court cases
Allegations of SRA have appeared throughout the world. The failure of certain high-profile legal cases generated worldwide media attention, and came to play a central feature in the growing controversies over child abuse, memory and the law. The testimony of children in these cases may have led to their collapse, as juries came to believe that the sources of the allegations were the use of suggestive and manipulative interviewing techniques, rather than actual events. Research since that time has supported these concerns and without the use of these techniques it is unlikely the cases would ever have reached trial.

In one analysis of 36 court cases involving sexual abuse of children within rituals, only one quarter resulted in convictions and the convictions had little to do with ritual sex abuse. In a 1994 survey of more than 11,000 psychiatric and police workers throughout the US, conducted for the National Center on Child Abuse and Neglect, researchers investigated approximately 12,000 accusations of group cult sexual abuse based on satanic ritual. The survey found no substantiated reports of well-organized satanic rings of people who sexually abuse children, but did find incidents in which the ritualistic aspects were secondary to the abuse and were used to intimidate victims. Victor reviewed 21 court cases alleging SRA between 1983 and 1987 in which no prosecutions were obtained for ritual abuse.

During the early 1980s, some courts attempted ad hoc accommodations to address the anxieties of child witnesses in relation to testifying before defendants. Screens or CCTV technology are a common feature of child sexual assault trials today; children in the early 1980s were typically forced into direct visual contact with the accused abuser while in court. SRA allegations in the courts catalyzed a broad agenda of research into the nature of children's testimony and the reliability of their oral evidence in court. Ultimately in SRA cases, the coercive techniques used by believing district attorneys, therapists and police officers were critical in establishing, and often resolving, SRA cases. In courts, when juries were able to see recordings or transcripts of interviews with children, the alleged abusers were acquitted. The reaction by successful prosecutors, spread throughout conventions and conferences on SRA, was to destroy, or fail to take notes of the interviews in the first place. One group of researchers concluded that children usually lack the sufficient amount of "explicit knowledge" of satanic ritual abuse to fabricate all of the details of an SRA claim on their own. However, the same researchers also concluded that children usually have the sufficient amount of general knowledge of "violence and the occult" to "serve as a starting point from which ritual claims could develop."

In 2006, psychologist and attorney Christopher Barden drafted an amicus curiae brief to the California Supreme Court signed by nearly 100 international experts in the field of human memory emphasizing the lack of credible scientific support for repressed and recovered memories.

In 2014, political science professor Ross Cheit published a book discussing his detailed review of satanic ritual abuse court cases, transcripts, and evidence, and concluded that while there was no evidence for the moral panic aspects of these cases, there was evidence in at least some of these cases that actual child abuse had occurred.

Dissociative identity disorder
SRA has been linked to dissociative identity disorder (DID, also known as multiple personality disorder or MPD), with many DID patients also alleging cult abuse. The first person to write a first-person narrative about SRA was Michelle Smith, co-author of Michelle Remembers; Smith was diagnosed with DID by her therapist and later husband Lawrence Pazder. Psychiatrists involved with the International Society for the Study of Trauma and Dissociation (then called the International Society for the Study of Multiple Personality and Dissociation), especially associate editor Bennett G. Braun, uncritically promoted the idea that actual groups of persons who worshiped Satan were abusing and ritually sacrificing children and, furthermore, that thousands of persons were recovering actual memories of such abuse during therapy, openly discussing such claims in the organization's journal, Dissociation. In a 1989 editorial, Dissociation editor-in-chief Richard Kluft likened clinicians who did not speak of their patients with recovered memories of SRA to the "good Germans" during the Holocaust. One particularly controversial article found parallels between SRA accounts and pre-Inquisition historical records of satanism, hence claimed to find support for the existence of ancient and intergenerational satanic cults. A review of these claims by sociologist Mary de Young in a 1994 Behavioral Sciences and the Law article noted that the historical basis for these claims, and in particular their continuity of cults, ceremonies and rituals was questionable. However at a conference in November 1990, psychiatrist and researcher Frank Putnam, then chief of the Dissociative Disorders Unit of the National Institute of Mental Health in Bethesda, Maryland, led a plenary session panel that proved to be the first public presentation of psychiatric, historical and law enforcement skepticism concerning SRA claims. Other members of the panel included psychiatrist George Ganaway, anthropologist Sherrill Mulhern, and psychologist Richard Noll. Putnam, a skeptic, was viewed by SRA advocates in attendance as using fellow skeptics such as Noll and Mulhern as allies in a disinformation campaign to split the SRA-believing community.

A survey investigating 12,000 cases of alleged SRA found that most were diagnosed with DID as well as post-traumatic stress disorder. The level of dissociation in a sample of women alleging SRA was found to be higher than a comparable sample of non-SRA peers, approaching the levels shown by patients diagnosed with DID. A sample of patients diagnosed with DID and reporting childhood SRA also present other symptoms including "dissociative states with satanic overtones, severe post-traumatic stress disorder, survivor guilt, bizarre self abuse, unusual fears, sexualization of sadistic impulses, indoctrinated beliefs, and substance abuse". Commenting on the study, Philip Coons stated that patients were held together in a ward dedicated to dissociative disorders with ample opportunity to socialize, and that the memories were recovered through the use of hypnosis (which he considered questionable). No cases were referred to law enforcement for verification, nor was verification attempted through family members. Coons also pointed out that existing injuries could have been self-inflicted, that the experiences reported were "strikingly similar" and that "many of the SRA reports developed while patients were hospitalized". The reliability of memories of DID clients who alleged SRA in treatment has been questioned and a point of contention in the popular media and with clinicians; many of the allegations made are fundamentally impossible and alleged survivors lack the physical scars that would result were their allegations true.

Many women claiming to be SRA survivors have been diagnosed as sufferers of DID, and it is unclear if their claims of childhood abuse are accurate or a manifestation of their diagnosis. Of a sample of 29 patients who presented with SRA, 22 were diagnosed with dissociative disorders including DID. The authors noted that 58% of the SRA claims appeared in the years following the Geraldo Rivera special on SRA and a further 34% following a workshop on SRA presented in the area; in only two patients were the memories elicited without the use of "questionable therapeutic practices for memory retrieval." Claims of SRA by DID patients have been called "...often nothing more than fantastic pseudomemories implanted or reinforced in psychotherapy" and SRA a cultural script of the perception of DID. Some believe that memories of SRA are solely iatrogenically implanted memories from suggestive therapeutic techniques, though this has been criticized by Daniel Brown, Alan Scheflin and Corydon Hammond for what they argue as over-reaching the scientific data that supports an iatrogenic theory. Others have criticized Hammond specifically for using therapeutic techniques to gather information from clients that rely solely on information fed by the therapist in a manner that highly suggests iatrogenesis. Skeptics claimed that the increase in DID diagnosis on the 1980s and 1990s and its association with memories of SRA is evidence of malpractice by treating professionals.

Much of the body of literature on the treatment of ritually abused patients focuses on dissociative disorders.

False memories
One explanation for the SRA allegations is that they were based upon false memories caused by the over-use of hypnosis and other suggestive techniques by therapists underestimating the suggestibility of their clients. The altered state of consciousness induced by hypnosis rendered patients an unusual ability to produce confabulations, often with the assistance of their therapists. Advocates of false memory syndrome (FMS), a controversial term promoted by the False Memory Syndrome Foundation, claim that the purported "memories" of ritual abuse are actually false memories, created iatrogenically through suggestion or coercion. The FMSF has used the idea of ritual abuse as a strategy to illustrate their position that most allegations of sexual abuse uncovered by the suggestive techniques used during recovered memory therapy are false "memories" of events that never happened. According to Kathleen Faller this has contributed to the sensationalization of the ritual abuse cases in the media.

Paul R. McHugh, professor of psychiatry at Johns Hopkins University discusses in his book Try to Remember the developments that led to the creation of false memories in the SRA moral panic and the formation of the FMSF as an effort to bring contemporary scientific research and political action to the polarizing struggle about false memories within the mental health disciplines. According to McHugh, there is no coherent scientific basis for the core belief of one side of the struggle, that sexual abuse can cause massive systemic repression of memories that can only be accessed through hypnosis, coercive interviews and other dubious techniques. The group of psychiatrists who promoted these ideas, whom McHugh terms "Mannerist Freudians", consistently followed a deductive approach to diagnosis in which the theory and causal explanation of symptoms was assumed to be childhood sexual abuse leading to dissociation, followed by a set of unproven and unreliable treatments with a strong confirmation bias that inevitably produced the allegations and causes that were assumed to be there. The treatment approach involved isolation of the patient from friends and family within psychiatric wards dedicated to the treatment of dissociation, filled with other patients who were treated by the same doctors with the same flawed methods and staff members who also coherently and universally ascribed to the same set of beliefs. These methods began in the 1980s and continued for several years until a series of court cases and medical malpractice lawsuits resulted in hospitals failing to support the approach. In cases where the dissociative symptoms were ignored, the coercive treatment approach ceased and the patients were removed from dedicated wards, allegations of satanic rape and abuse normally ceased, "recovered" memories were identified as fabrications and conventional treatments for presenting symptoms were generally successful.