Are Cults Harmful to Health?
Updated: Sep 26
Cults are often caricatured as fringe religious sects or bizarre communes, but their reality is far more insidious—and far more dangerous. Behind their various beliefs lies a predictable set of coercive strategies designed to control people’s behaviour, thoughts, emotions, and to destabilise their sense of self. In New Zealand, it’s estimated that between 50,000 and 200,000 people are either current or former members of high-control groups. For medical professionals, recognising the hallmarks of cult involvement isn’t simply an academic concern or a private curiosity—it’s essential to providing ethical, effective healthcare.
What Is a Cult?
The term cult isn’t about what a group believes—it’s about how it operates. West and Langone (1986) defined a cult as a group that demonstrates excessive devotion to a person, idea, or thing and uses unethical, manipulative, or coercive techniques to serve the goals of leaders, often to the detriment of members, their families, and their communities.
Cults can be religious, political, therapeutic, or even corporate. They can organise around spirituality, self-help, martial arts, therapy, business ventures, or family systems. What unites these diverse-appearing organisations is coercive control— a strategic social mechanism that creates dependency and fear, and leads to engulfment, exploitation and entrapment. Coercively controlling groups strategically isolate members from outside influences, manage information, stifle individuality, and manipulate relationships to maintain dominance.
Contrary to popular belief, most cult members do not knowingly choose such a life. Those born into these environments grow up in a world where fear, control, and obedience are normalised. When contact with the outside world is limited, there may be little opportunity to imagine that life could be any different.
Those recruited into cultic groups are often targeted during vulnerable periods and typically have little awareness of the deception involved in the recruitment process. Many are drawn in through manipulation, psychological grooming, and false promises about the nature of the group. The more harmful realities are often concealed until the person has become emotionally and financially dependent, socially isolated, and increasingly unable to leave.
Just as people rarely enter abusive intimate relationships expecting to be controlled or harmed, cult involvement usually develops gradually through manipulation that progressively erodes autonomy, critical thinking, and freedom.
Coercive Control: The Engine of Cultic Abuse
Coercive control is the thread that binds all abusive social systems. Dr Evan Stark (2007) defined coercive control as a strategic campaign of domination—not just isolated incidents of abuse, but a methodical takeover of a person’s autonomy through fear, surveillance, and psychological manipulation.
In cults, coercive control operates through familiar tactics: isolation, information restriction, emotional gaslighting, shame-based discipline, and induced dependency. In an environment where no questioning is allowed and leadership change up the rules on a whim, members internalise group ideology as absolute truth, and leaving becomes both terrifying and socially impossible.
Medical professionals may mistake a person’s total commitment to a controlling group as compliance, dependency, or passivity, when in reality it is often a survival strategy. Victims of coercive control are constantly making complex risk assessments, hypervigilantly evaluating which actions are safe and which may provoke punishment, rejection, or harm. When clinicians assume a patient “could just leave,” they risk overlooking the profound fear, entrapment, and silent desperation involved, and may inadvertently align themselves with the controlling system. Recognising coercive control as a hidden determinant of health is essential for ethical, trauma-informed care.
The Illusion of Free Will
A person cannot truly consent or make health decisions if their autonomy has been systematically dismantled. For informed consent to be possible the following three ingredients must be present; information, choice, and freedom. In closed coercive social systems such as cults, information is either withheld or faulty, there are no or very restricted choices, and the person faces serious consequences if they make a choice which conflicts with the will of the group - hence they lack freedom to choose. Informed consent is not possible in a cult.
Dr Janja Lalich, sociologist and cult expert, describes how high-control systems strip critical thinking and selfhood, replacing them with an illusion of choice. Members believe they are exercising free will, when in fact their every decision is shaped by manipulation, fear, and indoctrination.
Clinically, this manifests in patients rejecting care, avoiding treatment, or making harmful health choices that are framed as spiritual or moral obligations. To the medical professional, it looks like informed consent—but it’s actually coerced compliance for the sake of survival.
Children in Cults
The most defenceless victims are children. They never choose to join these groups, and they rarely have the means, freedom, or safety to leave. Parents within cults—often traumatised and controlled themselves—can become unwitting conduits for the leader’s demands. These demands frequently disregard children’s developmental needs and rarely accommodate individual health concerns such as neurodiversity, chronic illness, or disability.
In this environment, parents are often pressured to parent according to the ideology and peculiarities of the leader rather than their own instincts and understanding of their child. They may be required to suppress their natural protective responses in order to remain compliant and safe within the group. Over time, parents can become enforcers of the cult’s rules rather than protectors of their children’s autonomy and wellbeing.
Instead of nurturing children to grow into their own identities, cult systems constrain development and individuality. Parents who are themselves trapped within the system may end up teaching their children the rules of the cage, and how to survive within it, rather than how to live freely beyond it.
Cult leaders frequently position themselves as higher than family bonds, demanding absolute loyalty. This dynamic severs healthy attachment between parents and children, fostering environments filled with chronic fear, control, and emotional neglect. Many cult leaders actively separate parents from children, placing them in the care of adults with limited knowledge of and interest in them. Such active breaking of the attachment bonds between children and their parents opens the door for opportunistic abuse.
Children raised in cults face the potential for deep developmental harm:
Their individuality is often suppressed; exploration and expression are routinely punished. Identity development suffers.
Attachment disruptions can leave them without emotional safety and exposes them to risk of physical and sexual harm.
Education, healthcare, and nutrition are often neglected.
They are often trained to equate submission with virtue, leaving them vulnerable to future abuse.
This “fear without solution,” as Dr Alexandra Stein describes it, results in trauma, fragmented identity, and impaired capacity for trust and autonomy well into adulthood.
Recent survivor-led research by Surviving Universal UK found that 44.8% of respondents reported being born into a high-control group, rather than joining as adults. This highlights that significant numbers of cult members know no other life, and in fact may have been born to parents who also knew no other life. The report describes cultic abuse as an “intergenerational safeguarding issue,” highlighting how children raised in these environments often grow up entirely within systems of coercive control and may later raise the next generation in the same context.
Health Harms and Risks
The medical, psychological, and social consequences of cult involvement span nearly every dimension of health. While the ideology differs, the outcomes display disturbing consistency.
The following is a thematic list of areas of health injury commonly suffered by cult members and those who have left cults. It is not an exhaustive list, and not all people involved in cults are exposed to all risks. The degree of injury experienced is varied, and depends on personal factors including age and length of involvement, degree marginalisation within the group, personal medical vulnerabilities, and the degree to which the cult avoids or demonises mainstream medical care.
Healthcare Neglect
Symptoms are often spiritualised or dismissed. Members may be discouraged from seeing doctors or told illnesses stem from personal moral failure. Some groups promote pseudoscientific remedies or forbid medical intervention entirely.
Occupational Exploitation
Cults frequently profit from unpaid or underpaid labour. Members endure exhaustion, poor working conditions, and malnutrition—all under the guise of spiritual duty or community service.
Reproductive Coercion and Obstetric Risks
Control often extends to sexuality and reproduction. Contraception may be banned leading to high rates of pregnancies which women have had little choice about or, conversely, have forced celibacy, sterilisation or terminations imposed. Pregnancies may occur with limited or no medical supervision, with higher rates of stillbirth, birth trauma, and perinatal mental illness.
Sexual Health and Consent
Gender hierarchies and purity teachings can create environments in which abuse flourishes. Consent becomes deeply compromised when the social context makes it unsafe or impossible to refuse, or when submission and “yieldedness” are framed as virtues while bodily autonomy is treated as rebellion or sin. In many groups, sexual assault is minimised or reframed as a moral failing of the victim rather than recognised as abuse, leaving survivors burdened with shame, silence, and self-blame, and potentially publically punished. Research has identified alarmingly high rates of child sexual abuse and adult sexual trauma within coercively controlling groups.
Child Health Neglect
Routine vaccinations, screenings, and developmental assessments are frequently neglected. The unique needs of neurodiverse and disabled children are often completely ignored, with compounding disadvantage experienced. Education is heavily focused on or entirely limited to indoctrination, and children may end up with little knowledge of their bodies, how to conduct healthy relationships, or their rights to informed healthcare. A whole childhood of health education may be entirely lacking in some children raised in cults, who miss the foundational knowledge about health and wellness needed for healthy futures.
Preventive Healthcare Gaps
Avoidance of mainstream medicine leads to missed screenings, poorly managed chronic illnesses, and infectious disease outbreaks. Preventable disease presents late, with a resultant heavier disease burden than necessary and may even result in premature death.
Mental Illness
Cults foster conditions that are highly damaging to psychological wellbeing: chronic stress, suppression of individuality, emotional deprivation, and systemic gaslighting. In many groups, suffering is not only normalised but spiritually elevated, with members taught that enduring pain, sacrifice, or humiliation is virtuous or necessary for personal growth, purity, or salvation. Individuals may be pressured into marriages they do not want or with sexual partners of the wrong orientation. They may be required to remain in violent relationships, or be forced to temporarily or permanently separate from loved ones, with these experiences reframed as a pathway to spiritual advancement or eternal reward.
The psychological consequences can be profound. Studies of survivors report rates of PTSD approaching 60%, with complex PTSD rates as high as 76%. Suicidal ideation and suicide attempts are also many times higher than in the general population.
Social and Relational Dysfunction
Members conditioned for submission and compliance often struggle after leaving cults with boundaries, trust, decision-making, and self-protection. Survivors are at heightened risk of re-victimisation, including intimate partner violence, sexual assault, and recruitment into other coercive or exploitative systems.
Children raised in cultic environments may experience profound disruption to the development of identity and autonomy. Having been taught to suppress their own thoughts, needs, emotions, and preferences, many leave with little understanding of who they are, what they want, what feels safe or healthy for them, or how to navigate life independently. This deep identity confusion can contribute to significant difficulties in relationships, parenting, education, employment, and overall life direction.
Intolerance of Diversity
Most cults enforce rigid norms of gender, sexuality, race, and ability. LGBTQIA+ identities, neurodivergence, and disability are often pathologised or targeted. People of minority ethnicities may experience overt racism - justified by group doctrine - and be treated within the group as a member of the underclass.
Normalised Abuse
Doctrines often justify violence or psychological cruelty as discipline or faithfulness. Sexual abuse and exploitation may be woven into the fabric of the belief system such that non-consensual sexual contact is simply considered normal. Survivors may not recognise their experiences as abuse because they were taught it was divine, enlightened or deserved.
What about medical professionals who are part of the group?
Do cults that have their own in-house healthcare team achieve better outcomes for their members? At first glance, this may appear to reflect a community caring for its own. However, medical professionals such as doctors, nurses and midwives who are themselves subject to the group’s ideology and authority structures may be unable to provide truly independent and ethical care. In coercively controlling groups, the expectations and priorities of the leader often supersede the needs and autonomy of the patient.
Former members have reported being pressured by group-affiliated doctors or midwives to follow treatment pathways that aligned with the ideology of the group, rather than with evidence-based practice or the patient’s best interests. This can compromise informed consent, restrict access to outside opinions or services, and undermine the medical professional’s primary ethical obligation to the patient.
The Ordeal of Leaving
Exiting a cult is not liberation in the usual sense—it can be the most dangerous, destabilising experience of a person’s life.
Leavers face acute psychological stress, often without any material or emotional support. They may experience intense suicidal thinking and psychological overwhelm as they confront a world they were taught to fear. Psychological collapse, combined with a cult-curated paranoid belief system (implanted into the minds of members in a process known as fear indoctrination) can mimic acute psychosis.
Social death is common for the cult leaver: shunning, rejection, and the severing of every relationship with all group members when they leave. This is especially devastating for those born and raised in the group, who may have no relationships outside the group. For those born inside, even basic life skills—how to use money, laws, healthcare systems, or navigate relationships—may be entirely unknown.
Without safety nets, many survivors face homelessness, addiction, or exploitation. Stigma further silences them: society tends to blame cult survivors for their entrapment, interpreting manipulation as gullibility. This shame compounds their trauma and keeps them from seeking help.
What Medical Professionals Can Do
It’s easy to feel powerless when faced with such complex trauma, particularly when patients don’t openly disclose their cult experiences. Working out which of your patients may have had this difficult history can be very challenging. What is usually lacking is the time to hear the complex stories that these patients carry. But even within a short consultation, medical professionals can make a meaningful difference.
The following is a list of some key concepts to keep front of mind when treating a person who you suspect or know may be leaving, or have left a cult:
See the Person, Not the Stereotype - They are survivors, not oddities. Approach with dignity and empathy.
Minimise Power Gaps - Shared decision-making for a person who has never been allowed to decide can be both healing and triggering. Gentle collaboration helps rebuild autonomy.
Build Trust First - For many, this may be the first safe relationship they’ve ever known. Consistency and respect lay the foundation for disclosure.
Listen Deeply - Being believed—perhaps for the first time—can profoundly reduce shame and isolation.
Support Parents Reclaiming Parental Roles - Validate parents’ capacity to nurture and protect after years of undermining.
Create Space for Recovery - Where possible, support rest, time off work, or safe housing to allow decompression and processing. Sometimes time away from the group is the kick-starter to leaving.
Educate Yourself - Understand coercive control patterns and research specific groups where possible—without expecting patients to explain or to be the source of your learning.
Reframe the Conversation - Never ask “Why didn’t you just leave?” Instead ask:
What happened to you?
How did you survive it?
What support do you need now?
The goal isn’t to deprogram the person or to encourage them to deconstruct their belief system. Rather, what is needed from medical professionals is healthcare that recognises the loss of agency and systemic trauma underlying the patient’s life, and to support them to gain or regain bodily autonomy.
Cult Awareness as a Health Imperative
Cults thrive because they hide in plain sight—within families, workplaces, clubs, and therapeutic systems. While only a minority of people will ever join one knowingly, many patients will have been raised in, influenced by, or traumatised through one.
Medical professionals who understand the mechanisms of coercive control are better equipped to identify hidden abuse, contextualise unusual health behaviours, and offer trauma‑informed care. Recognising that loss of autonomy is a health condition in itself reframes how we engage with survivors—not as irrational oddities, but as people recovering from chronic systems of psychological captivity.
Bottom line: Cults are not fringe curiosities—they are systems of coercive control that produce measurable, multi‑system health harm. Understanding their dynamics is not niche knowledge but essential healthcare literacy. Recognising when a patient’s freedom has been stolen is the first step toward helping them reclaim it.
Where to Learn More
Professionals wanting deeper understanding can access the following information:
HealthPathways High‑Control Group Informed Care.
Accessible by clinicians all across New Zealand via your regional Healthpathways site.
The following presentation from Dr Kyle Eggleton and Dr Caroline Ansley is aimed at New Zealand medical professionals and summarises the pathway suite.
The Lalich Centre for Cults and Coercion
Offering specialise training in cults for mental health practitioners. Find out more here
Cult Chat Radio Show
Listen in to relevant New Zealand focused topics aimed at professionals working with cult impacted people. Hosted by Dr Caroline Ansley, Liz Gregory and Lindy Jacomb, this show educates about cult psychology and recovery care. For a selection of episodes see this page.
References
West, L. J., & Langone, M. D. (1986). Cultism: A conference for scholars and policy makers. Cultic Studies Journal, 3, 117–134.
Stark, E. (2007). Coercive Control: How Men Entrap Women in Personal Life.
Lalich, J. and McLaren, K. (2018). Escaping Utopia - Growing Up in a Cult, Getting Out, and Starting Over.
Stein, A. (2017). Terror, Love and Brainwashing: Attachment in Cults and Totalitarian Systems. Routledge.
Comments