The InterPsych Newsletter 2(9)

 


 

IPN 2(9) Section B: The Fifth Column


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VOLUME 2, ISSUE 9   THE INTERPSYCH NEWSLETTER     NOVEMBER, 1995
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                  SECTION B: THE FIFTH COLUMN

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| The following is a regular, independent column written by |
| Jeffrey Schaler, PhD.                                     |     
|                                                           |
| Opinions and comments are invited. Please send them       |
| to the IPN Mailbox (newsletter@fra.psych.nemc.org)        |
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                         BAD THERAPY
                   Jeffrey A. Schaler, Ph.D.

     "Psycho[therapists]:  Unmaskers of the insignificant,
     swindlers of the significant." --Karl Kraus, 1910 (1)

     "Ride _me_," he said.

     She had volunteered for the demonstration and was
systematically abused.  He had been selected by the
conference-planning committee because he was a "contemporary
master gestalt therapist."  It was October.  This was the Association
for the Advancement of Gestalt Therapy's First Annual
International Gestalt Therapy Conference.  The setting was a
plenary session in New Orleans.

     Over 250 people witnessed the event, described in the
     conference program the following way:
     Three Gestalt Therapists will work live with three
     different clients for approximately 30 minutes each.
     Each piece of work will be followed by the therapist
     discussing his or her work from both a theoretical and a
     clinical perspective taking questions and comments from
     the audience.  After the three presenting therapists
     have completed this part of the presentations, they will
     discuss the work (similarities and differences in both
     clinical and theoretical perspectives) among themselves,
     again encouraging dialogue with the audience.  All three
     therapists will be present for the entire session. (2)

     She, the second "patient," who looked to be in her
thirties, described difficulties feeling mature with men...He
told her she reminded him of at least one woman he'd known,
someone for whom he had previously had strong feelings...She
said she felt like a little girl with men...He told her he
found her attractive...She seemed distressed...He told her
she "resonated" a voice in his head...She cried
periodically...He told her she didn't know how to speak
English...She seemed confused...He told her she had
criticized him...She said she hadn't...He told her it was
someone else, but that apparently didn't make any difference
to him; she and the other woman meant the same thing...She
remembered going to the circus and riding the
elephant..."Ride _me_," he said...She was annoyed..."I have a
tough skin," he told her...

     Clearly the elephant man relished his ability to
manipulate a client.  At the beginning of their conversation,
this woman said she felt like a child in relation to men.
And what did he do in response?  He told her she was
attractive.  He told her to "ride" him.  She revealed a
vulnerable part of herself to him and he exploited her for
doing so.  What contempt for a client!  What poor character!

     _She_ "resonated" a voice in _his_ head?  And _she_
didn't know how to speak English?  _She_ was the same as
another woman?  _She_ shouldn't be confused and distressed?
What psychopathology on the part of the therapist!

     The assault called therapy ended soon enough. Audience
members took to the microphone and expressed varying degrees
of outrage:  "...I'm going to test the thickness of your
skin...That was the worst therapy I've ever seen...I'm
impressed with your ability as a mindfucker...And I'm
impressed with your ability to resist his mindfucking..."

     What's remarkable about this event is not just that it
was an example of bad therapy, for there is a spectrum of bad
therapy:  from relatively harmless to very harmful.  This was
very harmful.  What's more remarkable is that many people
watched and took no exception.

     For example, before the elephant man, a therapist
demonstrated gestalt therapy with a Russian psychologist.
The therapist overlooked any connection between the fact that
he'd spent 95 percent of his life in a communist society and
his fear of disappearing, his sense of emotional imprisonment
and his memory of his grandfather's exile to Siberia.  She
depoliticized and individualized his experience, perhaps the
most obvious thing about his life.  (This is ironic,
considering the importance gestalt therapists place on the
obvious.)  She ignored the larger context in which his
experience had undoubtedly developed.  (Again, the larger
context is a key principle in the theory of gestalt therapy.)
To her credit, she acknowledged the mistake publicly and
graciously at the plenary session.  Moreover, she didn't
overtly harm the client, despite a gestalt-therapy tradition
of abuse in the name of benevolent paternalism.  The high
priest of this religion, Frederick (Fritz) S. Perls, set a
standard for emotional abuse, a standard many of his
disciples still emulate.  This therapist had not abused her
client.  She had just missed the obvious.  The failure to
really see and understand a client contributes to the
client's desolation and despair.

     The "master therapist" in the third circus ring allowed
himself to be so controlled, so snowed, by his client that it
was like watching a marionette on stage.  She pulled the
strings and he changed his language or laughed without
knowing why.  He did whatever she wanted him to do.  The
proverbial hand, the proverbial balls.  The fact that she
stated she had difficulty dealing with the "hostility" of
others was irrelevant to him.  He was "grooving" with another
woman and "going with the flow."  The audience watched a
therapist make an idiot of himself and found this
entertaining.  Meanwhile, the client was confirmed in her
delusions of grandeur.

     A notable event!  The audience was presented with an
example of therapy at its worst under the pretense of therapy
at its best.

     Therapists who commit such acts in private are likely to
get away with it.  But publicly?  On stage?  Under the guise
of giving the best?  Having been selected for the job by
colleagues?  What grandiosity!  What viciousness!

THE "DAMAGE-CONTROL" SITUATION
     The elephant man never apologized, nor did he explain
the reasons for his behavior.  His colleagues tried to defend
his behavior, thereby reflecting their own lack of character.

     For example, they claimed people didn't really
understand him; to love him was to know him.  His character
as a therapist was supposed to be separate from his character
as a person.  (So much for holism.)  And if that wasn't
shocking enough, the grounds upon which people defended his
behavior come under the heading of psychosis:  the attempt to
fuse fantasy with reality, the symbolic with the literal.

     One therapist claimed it was inappropriate to evaluate
the demonstrator's behavior because one could not know what
his therapeutic "intentions" were.  But this is blatantly
untrue.  Behavior is intentional conduct.  We know what a
therapist's intentions are by observing his or her behaviors.
What a person does is _prima facie_ evidence of his or her
intention.  (Furthermore, a therapist who says one cannot
know what a therapist's, and thus a client's, intentions are
is admitting he or she is incompetent.)

     Was the demonstrator's behavior some kind of accident?
We know what a person's values are by studying what he or she
does.  That therapist did exactly what he intended to do.  To
think otherwise simply doesn't make sense.  (Indeed, if the
demonstrator had in fact done what he had not intended to do,
we would again say he was incompetent.)

     "There are 'multiple realities,'" argued another
therapist.  According to that "reasoning" we cannot know what
reality is because multiple realities operate in a
therapeutic encounter.  The client experiences one reality,
the therapist another, and every person observing the two a
third, fourth, etc.

     But that is untrue, too.  There is only one reality.  We
may each interpret reality differently, but there is no such
thing as "multiple realities."  Moreover, _believing_ in
"multiple realities" could be considered psychosis, as could
believing in the ability to create one's own reality.  We can
manufacture delusions, but not reality.  Thus, there are
people professing to be therapists who are themselves
fostering the mechanisms of psychosis.

     It follows that these same individuals would accuse a
critic of "imposing his reality" on "theirs."  However, one
reality cannot be imposed on another.  That, again, is
psychotic thinking.

     Those who were critical of the demonstrator were accused
of being too critical.  "You are so negative," complained a
therapist.  "Can't you find something constructive in what
happened during the demonstration?"  A psychologist from Los
Angeles chimed in and asserted that while he acknowledged the
substantial problems in the therapy demonstration, he admired
the therapist for his ability to "stay in the moment."
That's an interesting perspective, a curious admiration.
Consider what happened in the demonstration another way:  Say
a man literally rapes a woman.  The rapist concentrates on
the moment.  He "stays" in the moment.  What's to admire?
Then say a therapist emotionally rapes a client.  The
therapist concentrates on the moment. He "stays" in the
moment.  What's to admire?  His discipline?  Concentration?
Intention?

     And finally a professor of psychology argued that
"something good always comes from something bad."  She
relayed how she, too, had been abused by a therapist and had
learned something from the experience.  (The conspiracy to
exclude evil was now complete.)  Fortunately for her, she
thought it over when her husband told her she was protecting
someone she hated.  She awoke from her trance and
acknowledged she was wrong.  The reality was that something
terrible had been done to her.  The therapist had robbed her
of years of the freedom to live wholeheartedly.  Nothing good
had come of it.

SPEAKING TRUTH TO EMPOWER
     Amos M. Gunsberg, a psychotherapist in New York City,
has long cautioned the public against damage and corruption
committed by psychotherapists:

     [F]or a therapist, supervisor, or teacher at a
     school of psychotherapy, the PRIMARY QUALIFICATIONS are
     GOOD CHARACTER and EMOTIONAL STABILITY.  Deficiencies in
     those areas are the main source of DAMAGE to the
     patient.
          The public is under the impression that a
     psychotherapist MUST have undergone a thorough analysis
     so that the patient is protected against being abused
     and exploited.  This is NOT the case!  As far as I've
     been able to discover, NO institution or agency or
     organization of psychotherapists vouches for the
     character or emotional stability of the people they
     graduate or give certification to. (3)

     In 1989 I publicly advised a psychiatrist about what to
do with a patient of hers who deliberately infected people
with AIDS. (4)  Now I advise clients, colleagues and the
public about what to do with dangerous therapists.  Any
therapist who has committed the kinds of acts described
should terminate his or her practice and teaching of
psychotherapy immediately.  He or she has no business being a
therapist and/or a teacher of psychotherapy.  Clients who
feel damaged by a therapist's behavior are encouraged to seek
reparation with the assistance of a third party.  If you are
in doubt, tape your therapy sessions.  Do not work with a
therapist who refuses to allow you to tape your sessions.
The therapist should supply the recorder, so that all you
need bring is the tape.  Demand from your therapist copies of
the ethical codes of the state, the school, the professional
organization.

     Therapists should muster the courage to censor unethical
practices and speak out not only against specific individuals
but also against the institutions and guilds that condone
such behavior through silence or worse through self-serving
rationalization.  Anything less is collaboration.

     Harvey Keitel had it right in the movie "Pulp Fiction"
when he remarked: "Because you _are_ a character doesn't mean
that you _have_ character."  It is an outrage when people
paint the perpetrator of a crime, be it a literal or
emotional one, as more of a victim than the person he or she
has assaulted.

NOTES
(1)  Szasz, T.  (1976).  _Karl Kraus and the soul-doctors._
     Baton Rouge, La.:  Louisiana State University Press.
(2)  Association for the Advancement of Gestalt Therapy.
     (1995).  First Annual International Gestalt Therapy
     Conference Program, October 12-15, New Orleans, La., p.
     18.  [Elaine Kepner did not attend the plenary session.]
(3)  Gunsberg, A.M.  (unpublished manuscript).  _Caution:
     Your psychotherapist may be dangerous to your health!_
     New York, N.Y.
(4)  Schaler, J.A. (1989).  AIDS and the psychiatrist's
     dilemma.  _The Washington Post_, March 15, A22.


Jeffrey A. Schaler, Ph.D., teaches psychology and public policy at
American and Johns Hopkins universities and is the listowner of
NUVUPSY@sjuvm.stjohns.edu and co-listowner of SMARTREC@sjuvm.stjohns.edu.
He lives in Silver Spring, Maryland USA.  (jschale@american.edu)