In affluent societies such as ours, self-help courses are popular. Wallets open for the idea that over the course of a weekend or a few weeks you can have your life transformed. But self-help courses can be legally controversial, as the Sydney inquest into the death of 34-year-old Rebekah Lawrence is revealing.

Ms Lawrence attended an intensive self-help course only days before jumping out a Macquarie Street window. Whether her participation in the course had anything to do with her death is obviously yet to be determined by the coroner.

But the Lawrence case is not the first time a self-help course has been scrutinised by the courts. The Landmark Education Corporation, which runs The Forum, one of the most popular self-help courses in Australia and across the globe, has been a litigant in several US courts in the past two decades.

Twenty years ago, Stephanie Ney attended a Forum course over a weekend. But in the days following her attendance she began to unravel. As the United States Court of Appeal noted in a 1994 judgement in which Ney was suing Landmark Education:

Ney began a process of psychological decompensation.

At the end of a three-day period she had a psychotic break with reality, suffered apparently permanent psychological injuries, and had to be hospitalised at the Psychiatric Institute of Montgomery County for 14 days.

While in the hospital, she was medicated and at times strapped to a bed in four-point restraints to prevent her from harming herself.

Unfortunately for Ney, the US Court of Appeals said that “although perhaps her participation in the Forum might have led in part to her psychotic reaction, even if that nexus had been established, [she] did not produce sufficient proof to recover under Virginia law.”

But the court acknowledged that “there is much in the record suggesting that Ney’s psychological difficulties are real and quite terrible”.

In Oklahoma, the family of a man shot by 27-year-old Jason Weed in 2001, have sued Landmark because Weed attended one of its courses only a few days before the shooting. The shooting was caused by Weed suffering a brief psychotic disorder, although his own psychiatrist could not determine the nature of the mental defect that caused it.

But the US government psychiatrist who examined Weed said that his “previous steroid use and participation in an exhaustive self-awareness program the week  before the shooting could be ruled out as causes of the psychotic break.”

Landmark Education Corporation itself has been a regular initiator of litigation.

In Europe and in the US, the company has vigorously pursued those who have called its courses a cult or cast doubt on their psychological integrity. Most of these cases, brought against journalists, authors, psychologists and magazine publishers, have been settled out of court.

A survey of the case law about the impact of self-awareness courses such as The Forum and Turning Point — the course attended by Ms Lawrence — on the psychological profile of those who attend them is so far ambiguous. And the regulation of such courses is similarly vague.

Despite the fact that such courses are a multi-billion dollar industry, the law’s capacity to set clear ground rules around liability remains murky 30 years after their advent.