Jeffrey A. Schaler, Ph.D.

The InterPsych Newsletter 2(9)


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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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Note: The Fifth Column is a regular PsychNews column, managed by Jeffrey A. Schaler, Ph.D.
Opinions and comments are invited. Please send them to the PsychNews Int'l mailbox: psychnews@psychologie.de
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(Editor's note: Please see the July 1998 issue of Psychnews International at http://www.psychnews.net/1_5/index.htm)

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)