What Kept Elizabeth Smart From Escaping?

March 14, 2003 -- After nine months, Elizabeth Smart is back home. And this is raising questions about how her captor kept a 15-year-old from escaping when she may have had opportunity. Was she brainwashed?

At this point, details of her ordeal remain a mystery. But psychologists voice a few opinions about Elizabeth Smart's state of mind during her disappearance.

Some liken it to the so-called "Stockholm syndrome," referring to the 1973 bank holdup of four Swedes for six days. During that time, the four bank employees became emotionally attached to their captors.

"Stockholm syndrome is not brainwashing -- it is a means to endure the violence, a survival technique that the brain uses," says Alan Hilfer, PhD, child psychologist with Maimonides Medical Center in Brooklyn. Brainwashing typically involves withholding food and sleep, he says. Yet Elizabeth appears to be healthy.

He speculates that in Elizabeth Smart's case, she came to identify with her kidnappers. She began to understand and empathize with their reason for kidnapping her -- whatever that reason was.

"It's not a conscious process," Hilfer explains. "It's not that she made a conscious decision that these people were right to kidnap me. It's her mind trying to understand the horror of the situation and justify the reasons for it. It's the mind's way of saying 'This is what I need to do survive. I need to believe there's a reason for this, that these people make sense in their demands.'"

For Elizabeth Smart, this unconscious attachment to her captors could develop to prevent more harm. If she resisted their violence, she likely would get beaten more, for example. But if she says, "I understand, I understand," she won't get hurt as much, he tells WebMD.

This attachment process takes time to develop, Hilfer says. "It's a process of indoctrination. It's why a girl who appears to be a relatively bright, articulate 15-year-old doesn't run to a policeman in a town 15 miles away from her home. It's because there's a level of identification with her aggressors."

Barry Rosenfeld, PhD, a forensic psychologist at Fordham University in New York, has another opinion.

He has doubts that Elizabeth Smart was experiencing Stockholm syndrome. If she was, she would have put up more resistance to rescue efforts, he tells WebMD. "She certainly wasn't ripped from her abductor's arms, kicking and screaming, saying 'No, I don't want to go back home.' There's no reason to believe she didn't want to go to her family."

Rosenfeld offers other scenarios: Elizabeth's captors may have lied to her. She may have been told that her parents had been killed. She may have been told that her parents or sister would be killed if she tried to escape.

Because of her age, Elizabeth is not the typical abducted child, Rosenfeld acknowledges. "When a 14-year-old disappears, the first thought is that she's run away. But I don't see any basis for that. She certainly didn't seem reluctant to come home."