Hope this helps! The counselor through this teenage boy employed his mother to clean his offices and talk about whether or not it has been done during his sessions. The Counselor texts about appointment times as late as 10pm and on weekends really odd?? The Counselor had the boy help him fix his car. The nephew is now in our care and just turned He has behavioral issues that are being treated with medication and we entered him into baseball because we felt that would help him. So much that he asked if he could go from seeing his counselor from every week to once a month at least through baseball season.
I spoke to his mom and she said it was fine for now. When talking to the counselor he made a huge deal about it. Saying there was no way he was ready for anything like that and that he needs to talk to someone every week. He also talks to a lady from county mental health department. According to the boy the lady from county mental health talks to him about way more issues than the counselor does. The Counselor then contacted the mom and pushed to where the boy has to go and see him every 2 weeks.
According to the boy all the Counselor asks him is how school is and then tosses a ball back and forth. Now to the nitty gritty of the matter.
This boy has been emotionally and physically abused by all the members of the house hold Mom, step-dad, older brother and sister. The Step-dad emotionally and physically abuses everyone in the household.
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The boy was removed and brought into our care. According to his mother DFS has stated that if the step-dad completes anger management and AA then the boy will be allowed to return home. So, the abused and the abuser would be seeing the same counselor. Is this a conflict of interest? When I was the child in this situation, none of us were allowed to see the same counselor. No matter what they will be talk about each other.
The counselor is not going to completely forget their sessions and may draw upon what is said from one session to the next. I am also in fear that because of his very unprofessional actions and the relationship he developed with the mother that things are going to be simply swept under the rug. I do not want him to go back home to the same situation or to a worse one.
I feel things could possibly get worse, if the parents feel that they can get by with things due to improper investigations and counseling. There is nothing really to stop a counselor from signing off on paper work that they completed a program or has done well. The boy likes living here and does better here but wants to be with his mother.
She in fact left her children at her parents home to meet a man in Illinois and did not tell any one of her plans. He was very very young at the time. I would say he was not even one or close to one. She did not return to get him until he was 4 almost 5. Then a year after that she came back for the rest of her children. What do you all think about this?
When I expressed my concerns about the step-dad using the same counselor, she yelled at me stating it was none of my concern. However, while in my care the safety and well being of the child is my concern. The state should have done more in my opinion. When I tried to call back for my records the joint called the police on me and then the frightening rude intrusive provocative questions…and this was four days after I was sprung from this horrid illegal imprisonment!!
This attempted police bust was a possible outcome. Nice therapy I must say. And the records never did come. I am thinking at this point a certified letter with copies to the licensing board? She left me flat with no referals nothing. I am very sorry to hear of your experience of therapeutic abandonment, considered to be one of the most egregious problems in field of psychotherapy. I hope you will not be too discouraged by this experience which is unusual and fairly rare I would say and that you will find another therapist very soon. I think if you the therapist cares about you, tells you he or she can help you, and you see yourself making some progress, then keep going back.
The answering phones during session, this happens with my therapist. On the other hand, when I have a problem and need guidance, he answers the phone almost 24 hours a day. Or go visit other therapists as well and look for a good fit. Ask around for referrals and ask what the therapist will be able to do for you or what positive outcomes you can hope to achieve in counseling. Then stick it out. I have to disagree. You t should never talk on the phone, keep looking at her cell or have any other distractions when they are speaking with you.
That is time that you had often pay dearly for. Any therapist who answers a phone in session is just downright rude!! End of story, no exceptions. There is simply no excuse to put your phone ahead of the distressed person in front of you. I have never even seen her with a phone in her hand.
I have another perspective about answering the telephone during sessions. The impact on my session was devastating. The phone rang excessively right in the middle of my discussing how difficult the therapy was for me. He did not take it, but when I asked what would happen if he did need to take it, he replied that I would need to step out of the room. I immediately imagined that if he asked me to step out, I would walk out and never return. All I can say is that I cannot imagine being in the middle of a really difficult moment, even more than I already was and having the phone ring and ring.
As a therapist, I am always apologetic and quick to act when I accidentally leave the ringer or my voice mail on and there is a disruption in a therapy session. Sometimes intrusions are unavoidable, they happen. But how can one ever really relax into a session, knowing that the therapist is allowing the intrusion? I will discuss this further with this therapist, but am losing hope about a positive outcome.
Your analyst sounds like a narcissistic and rather incompetent person. Please consider expressing your emotions to him and then finding another therapist. Thanks for this excellent list! We post our client rights document and privacy statements in the waiting room and keep copies there for clients. In addition, all of our clients receive, read, and then sign and informed consent document, a copy of which is also in our waiting room and on our website. My Therpist still will not give me my file or any pictures ect. She did everything wrong when she terminated our sessions and she knows it.
I have never felt so bad she left me now with bigger issues. I feel ashamed that I ever went to her and confided in her regarding my abuse, I feel like she was the bigger abuser and to start all over will kill me to much stuff. If the you were seen with a partner, then the therapist would need consent from all involved, or their guardians. If the file only concerns you, then under HIPPA regs you are entitled to view the file and make or have made copies at reasonable cost. If there is a lawsuit pending, that may complicate matters.
Hi Violet, I really appreciated your comment about therapists who cry. For example, you may have also felt like she pitied you. Whatever the case, I believe that your therapist was pushing your button by crying, but that it is your button. My hunch is that this could be a wonderful opportunity for you to explore your feelings about being vulnerable. So I highly encourage you to talk with you therapist about how you are triggered by this, rather than stop therapy. Finding a therapist who is less triggering could be less productive for your therapy and there may be many gifts and treasures to discover by exploring this.
I will add that the sharing of emotion technically called intersubjectivity can have a very positive and healing effect for persons, especially those who have experienced trauma and who may feel alone, uniquely violated, and defective because of the abuse. Sharing affect with a client can make the emotions less disturbing and help the person feel understood on a very deep level. My therapist is a lovely woman except she has on numerous occasions started to cry during my sessions not sobbing!
She is very professional in every other sense although this to me is inappropriate and very unprofessional obviously leaving me feeling very uncomfortable! Would be interested to know if this has happened to anyone else? I have stopped my therapy with her, it got too much. Empathy notwithstanding, it does reek of unprofessionalism however unintended.
I would forgo the psychobabble that casts doubt on your perceptions and preferences, and find someone else. She learned she was pregnant by the 2nd visit we had and from that point on I became the listener during our sessions. I was not trying to surprise or hurt her feelings, but she was aghast in surprise. It was a much better experience with the therapist I got 6 yrs.
I would return to her, but to be an informed therapy consumer takes alot of work. Are professional geriatric care managers a trustable resource to help one select therapy providers? I have concerns about conflicts they may have much like the drug trial researchers who also maintain private practice. I still have insurance, but co-pays are considerably higher now. Cost-effectiveness is key for me. A decent source of referral is your PMD primary care physician. You could also consider asking trusted friends.
Please add to your list Therapist uses your insurance to committ fraud then blames you for being impulsive and indirect when you turn him into the insurance company…. I went to a therapist for almost 4 years. She helped me see that I needed to have my partner in therapy too.
Her whole program is based on finding your truth and being in truth so this was considered brave work. My husband did not want to go to this therapist because he felt she and her partner husband were cultish. They have a book and a forum. She warned me about other therapists, but I found some one for marriage counseling.
Meanwhile I still saw my therapist. Our sessions ended up being a dissection of the marriage counseling. She finally announced to me that I needed to make a choice to really dig in or not become enlightened. She said her training made her especially capable of making these judgements.
This felt like control by threat. I finally did leave the original therapist, but I have struggled with the quitting and feeling like a coward ever since. Does this seem kosher? He has pressured my spouse to get me to also come for marriage counseling. I thought it was unethical to see a couple for marriage counseling and at the same time see one of them individually. My husband also had an emotional affair with an old high school flame, with whom he met secretly for lunch dates for two years behind my back.
Who is this guy advocating for, anyway?? My therapist obtained my consent to speak with his therapist, after which time he dropped the request for a therapy session that included the other woman. I think this guy is scary and that my spouse should find s different therapist. Should he find a different counselor based on these facts? While they intend to support your self-esteem, validate your experiences, and build your confidence; they can create an inhibition on your part to reveal less attractive thoughts or behaviors of yours, for fear of losing their positive regard towards you.
They may have removed themselves from the experience because the emotion was too painful. Depending on wether the client is ready to explore that emotion relating to their experience, they may move forward with the exploration, or away from the theraputic relationship. It seems to me that many children suffer a sort of dissociation from their feelings as a result of parental rejection, hostility, anger and displeasure; and try to defend and appease their parents by not showing an emotional response that would only further inflame their parents, or caregivers.
Therefor, the therapist in demonstrating the emotion, can help the client in articulating the problem. Young children can suffer much abuse before they become able to well represent what has happened to them in verbal form. Without being able to use language, there are very limited ways to record this, which tends to be the reason many people do not remember their early childhood. Even in early childhood, critical and abstract thinking are not available to record what has happened to one, and so the cause and effect of situations often can not be remembered by an individual in a way they can make use of.
Often only the emotion can be used to pull that experience out, in order to look at it, and deal with it, grow, and move on. I feel like I am having some issues with my therapist lately. I need a letter of clearance from her for a fertility clinic so that I can be artificially inseminated. She then feels like she needs to talk to me about my plans and offers me parenting advice which I never ask for.
Very standard practice. You make a number of excellent points here. I would like to just under score and amplify one, if I may. As is often the case with children, especially those who have experienced chronic early maltreatment within the caregiving relationship, adults may have difficulty knowing what they feel or experience. In many ways, this reflecting back of the emotion and experience is what occurs in a healthy parent-child relationship and is an essential part of the development of a healthy and secure pattern of attachment.
The developing infant and child comes to know what the child feels by seeing it reflected in back from a responsive, sensitive, insightful caregiver. Hows about therepists who ignore the issues you want to talk about, and press on things you dont regard as important? I had a therapist who kept trying for things in my childhood or family,, and I had to fight to try to talk about what I wanted to talk about.
This happens to me, too. Not in every session, but a lot. Once I wanted to say how I became angry at some man who stepped into the garden no fence against my will…. The therapist pushed to talk about another issue which he prepared, so I gave up. It was not that bad… I hoped I could raise it some other time. Many other sessions the therapist started to distract me from the topics I wanted to talk about -all those who were not related to my childhood, usually it ended up by a completely different issue that the therapist talked about his favorite -sexual experiences, even though I was not in relationship , it was as he wanted to push me into these topics despite my current energy and feelings were somewhere else.
At the end of those session I was confused. I could have not talked about what was happening to me. I tried to bring up my current issue again and again a fight with the therapist. The therapist said couple of phrases to my share and started another issue…often very mind-related and I gave up.
I tried to follow the therapist- topics in my mind. I guess it means that I needed to process my emotional and body experience from the trauma and I was distracted from them into my mind, by also choosing another topic the one the therapist considered important. I never asked directly :are you a PTSD specialist, do you have any experience?
My life from birth through my mids was a mess of chronic horrifying stuff mixed in with jolts of new awful events. All anyone needs to do is to live in the present-day reality as best they can, without being distracted by flashbacks. I practiced Staying in the Present many thousands of times over several years, and got more and more and more relief as my reactions got quicker.
As I said, just a thought. I also have had a few unfortunate experiences with professionals who are supposed to help, and never hurt. My psychiatrist of 9 years terminated by sending me a form letter — she actually just put my name after the Dear… part. That was it. The damage she did — it was one of the hardest things for me to handle.
I just can not understand why anyone, but especially a professional, would treat someone like that. Needless to say, I now have more trust issues than ever. Does anyone know if this is something that could be reported? Dear Mara, In thinking about the termination through the letter, I have a couple of questions. One, had you been seeing this psychiatrist regularly? Two, has there been a long time since your last appt. Sometimes a clinician cannot have a patient on their caseload who is not keeping appts.
It actually becomes a liability for them. They have no choice but to terminate after several attempts to schedule or contact you. If she is leaving her practice entirely, a letter may the way she notifies a large case load. If you have been seeing this psychiatrist regularly, I would indeed imagine that you would feel hurt by this kind of notification. This is worth discussing with her. She would need to know the impact of this letter on you. It is clear though that you do feel hurt by this, so I encourage you to contact the psychiatrist to express yourself.
I have had a couple of practitioners who have eaten during a session. One ate a Whopper there was a Burger King next door , the other, an apple. I never said anything, but I was mildly irritated. I also had a therapist that would sit and wait for me to say something and get mad that I was not working at it.
As i worked with her futher she changed a lot she was not warm and fuzzy any longer but hard and mean. When she did dump me she said she no longer looked forward for me coming to see her, and i became harder to work with….. When I did discuss this with her she told me I have a personality disorder were did that come from?
I am sorry that you had such a terrible experience in therapy. I am a LMHC who has been working with survivors of sexual abuse for years. Not once have I made a client feel so uncomfortable. Most of my clients have told me several times how grateful they are and how much therapy has helped them.
Please do not give up on treatment. It really does work once you find someone you can connect with. Best wishes! These have been excellent issues and a very good discussion. As moderator of this blog thread, I decided to post the above comment by Trace because her second paragraph is quite supportive and valid. I removed it. Also, be aware there are some Social Workers who have Drs in other fields. LCSWs can have just as much or more post graduate training in psychotherapy as any psychologist. Also, the idea that social workers do not adhere as strictly to their ethical guidelines as psychologists do to theirs is false and terribly misleading.
In fact, the ethical guidelines for Social Workers are highly respected in the field of mental health as an enormous effort to prevent harm. I am surprised the comment was removed; it does not sound slanderous at all. What you said about social workers adhering to their ethical standards as much as psychologists do is of course absolutely true.
Ethics standards for Psychologists are simply much stricter in many areas; they are known to have the tightest ethical standards in the U. I am also surprised to hear you say that some social workers can have as much psychotherapy training as any psychologist. All psychologists have a minimum of years of graduate training after college, and most get additional training and practice beyond that before getting licensed.
You are welcome to correct me, however, if I am wrong…. A therapist should be considerate and able to adapt or find a kind way to explain why it is important they do what they do. If it still does not feel right for you, report them to their licensing board! All licensed therapists must make this information available to you upon request. In any event, the administrator is correct. If one goes to the website for the National Association of Social Workers and reads the code of ethics it is every bit a stringent, specific, and highly ethical as that of those who belong to the medical professional and psychology profession.
Those with a MSW must do an internship that accounts for about half of the required 60 credits. A MA in psychology, for example, only requires 30 or so credits and no internship. To be licensed LCSW, for example usually requires passing a National test, presenting verification of a certain number of years experience varies by state and letters from supervisors. Good Psy. Sure admin, chiming in here about the LCSW vs.
The research is very clear neither discipline is better than the other in terms of therapeutic effectiveness and this finding is across disorders. Years of experience is also not at all correlated with effectiveness. Thank you for the site and the interesting topic. First let me clarify. In the State of California there is a written and an oral exam. The oral exam is now a written series of Vignettes. This is by choice as I work for the federal government and could just take the national exam and leave it at that.
It has taken me 6 years counting 4yrs undergrad to complete the degree alone. And two years minimum to complete the post degree hours of supervision. As a case manager and addictions counselor. Now as for the degree it self. It was required that I complete a minimum of 80 units. It is counted as Hrs. In social work this is a true internship and it is part of the curriculum to qualify for the MSW degree. Very much like the medical degrees. You must complete during your degree!
This is usually completed within two years but in some cases with approval from the academic standards board at the University, you can extend the degree to three years. That requires the student to attend a major university. The standards for the MSW degree are huge. For good reason, the MSW degree is also the oldest mental health degree and profession in mental health, except psychiatry. I have therapist I rely on that is an awesome guy. He is a PsyD and a wonderful therapist and person. The ability for two people to relate and communicate on even ground with trust and honesty.
This process takes time, patience and requires focus on the relationship. Credentials are very important as well as licensing. What is a LCSW? Clinical Social Work Defined Clinical social work is a practice specialty of the social work profession. It builds upon generic values, ethics, principles, practice methods, and the person-in-environment perspective of the profession.
Its purposes are to: Diagnose and treat bio-psycho-social disability and impairment, including mental and emotional disorders and developmental disabilities. Achieve optimal prevention of bio-psycho-social dysfunction. Support and enhance bio-psycho-social strengths and functioning. Clinical social work practice applies specific knowledge, theories, and methods to assessment and diagnosis, treatment planning, intervention, and outcome evaluation. Practice knowledge incorporates theories of biological, psychological, and social development. It includes, but is not limited to, an understanding of human behavior and psychopathology, human diversity, interpersonal relationships and family dynamics; mental disorders, stress, chemical dependency, interpersonal violence, and consequences of illness or injury; impact of physical, social, and cultural environment; and cognitive, affective, and behavioral manifestations of conscious and unconscious processes.
Clinical social work interventions include, but are not limited to, assessment and diagnosis, crisis intervention, psychosocial and psycho-educational interventions, and brief and long-term psychotherapies. These interventions are applied within the context of professional relationships with individuals, couples, families, and groups. Clinical social work practice includes client-centered clinical supervision and consultation with professional colleagues. Adopted 12 Feb.
Very nicely stated. Thank you for taking the time here. As you mention, the internship standards are pretty intensive and the requirements for licensure are also very stringent. Yes the MSW degree is just that, a professional degree. Which is a little different than an academic degree you mentioned. Mainly, for the obvious purpose of referral and using our strengths in the mental health field as professionals to better help our clients.
We all know people who may be of a different degree or background that excels in a certain type of help they can provide a client. No one wants to think that they have nothing to offer a client. But, all to often that is the case. I think it is imperative that we as profession begin to operate similar to the medical profession.
They form medical groups and they have their specialists in certain areas who like what they do and do it well. There should also be some front line general practitioners in our field. Mental health groups of all backgrounds would help facilitate this, much like medical groups.
But we all must be able to recognize our own limitations. Whether it is personality, skills, education or personal background. My Old Therapist would make me wait for 20 minutes cause she was starving as I read an old magizine she chomped on her to go lunch.. What a rip. I personally would walk out of the session or prior to the 20min being up if my therapist treated me that way. No excuse. On Dual Relationships. Dual relationships can be unethical and illegal, they can also be unavoidable or even mandatory, yet some dual relationships are clinically beneficial.
We need to be flexible and learn that the meaning of dual relationships can only be understood within the context of therapy. Ofer Zur. I think you make a good point, which is that the relationship between you and your therapist is what is essential to getting help and benefits from therapy. Always assuming your therapist is licensed and appropriately trained for your issues.
I note, however, that it is not so much the training that has been important as it has been the connection we were able to establish …. I have been seeing a counselor for 16 years for many family events. I cannot afford to see her now. I am not sure what to do. I feel guilty but I am more comfortable with her. Also the second counselor keeps her uneaten lunch supplied by the drug reps in her top drawer to munch on between appts:. I appreciate the opportunity to share my experiences.
During my 4th brain injury recovery I too was hugged after each session without being asked. I have a hard time with boundaries and confrontation so I discontinued therapy without explanation even though I really needed further help. I am online seeking that help now after 7 years and noticed this blog.
What I needed was to overcome fear and devise compensating learning tactics. Since then I have earned a 3. I doubt those counselors could match that. I regret skipping college due to my fears, lack of understanding my brain injuries and listening to really bad advice from ignorant school guidance counselors. Think about adding the following item to your list.
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They should not discourage you from honorable goals. I have gratitude for many clients that show dedication and trust in their treatment with me. Some work harder than others, some more internally motivated than others. I strongly believe that I have an ethical responsibility to continue to see internally motivated clients although their ability to pay has changed. Do I owe that same loyalty to those who are only externally motivated? No, because it would be a disloyalty to keep someone in therapy that is not clinically progressing regardless of their ability to pay.
If a client is committed and loyal to their treatment, then yes, I would and have reduced their fees to what is reasonable for that client at that time. In the event that a potentially new client cannot afford the services, there are many community counseling services that receive funding for those who are financially limited and in need of therapy. As these economic times have become fragile in the past year, I have had a couple of very motivated clients who have been laid off from their places of employment and they have lost their health insurance by no fault of their own.
Many clients have issues of past abandonment with authority figures or persons they had entrusted. I believe that refusing to see them in their time of financial crisis would be ethically irresponsible and clinically would be considered to be an issue of abandonment. So, Denise, it looks like you have a great topic for your next session…how has this issue revealed clinical significance on your issues you are addressing in therapy? PS-I love this forum! Very thought provoking as a therpaist and excellent real life continuing education. To add another to the list: A therapist telling you not to talk about certain issues, i.
Supposely the woman gave her one diagnosis to then change it. They are obssesed with each other and that leads nowhere. It is plain bullshit that you can file a complain and hold them accountable.
Noone should have that much power. This is a sign of poor organization in my opinion, distracts from the work at hand, and is terribly disruptive. If there is not one, then the likelihood of it occurring and your being able to do anything about it during the 50min we are together is unlikely. Please answer the calls between appointments, at night or in the morning. Being always available is not helpful, and a lot less productive. Dual Relationship? I was seeing a therapist for depression, anxiety, and numerous emotional issues. During one of my sessions she asked if I wanted some tea she was seeing me at her home as she was going to make some, I said no thank you.
When she returned with her cup of tea she sat down and brought up a completely different topic, with no correlation to the prior subject. This will be my last session. I appreciate this website very much, and am glad you posted warning signs to help educate us as patients. God Bless you, and may your hearts be healed so you can enjoy the beautiful things life has to offer each and every one of us. They are also not taking any new medicare or disability patients. I do see another therapists off and on now and they keep asking me if i am seeing her. I think they will drop me if i am.
I too was seeing a therapist for a number of years. I had a good relationship with this person, and started to heal. As I developed other supports, that the average person would have, such as friends, a faith community and a chosen family, the therapist naturally stepped into the background. Then the friends died, the faith community kicked me out and the chosen family left and moved out of the country. I was still seeing the therapist, at the time, but the therapist has not given me an appointment in over 15 weeks, prefering instead to have me check in by phone leave a message and would call me back and leave a message.
Granted I was not being charged for this, but found it highly annoying. I had an outstanding balance due, which was scheduled to be paid from the next paycheck and I went out on disability, and the payment was delayed only until the disability payments started coming in. The therapist has now been paid. However things have deteriorated to the point where I no longer feel comfortable talking to this person…. I am all done. I think it is a great way for both professionals and consumers to keep up to date and really see the concerns people are having.
What I find so distressing is that many professionals are not helping their clients understand the therapy process, and what its all about. I am saddened to have read so many accounts of unprofessional behavior. I always encourage people to be informed consumers, and to know the different ways that you can file a complaint if you feel that you have been a victim.
I also encourage people to keep the dialogue open if you feel that something is off about your therapist, or your therapy. Sometimes, it can be very beneficial to openly discuss your concerns about certain behaviors, such as the eating during sessions, taking phone calls, excessive wait time etc. As an MSed and LPC I had to complete a masters degree of 60 credit hours from an accredited university, plus over clock hours of true internship experience. After this was completed, in order to be licensed by the board in the state of Ohio, I was required to pass the National Counselors Exam,and background check.
From my experience I have learned that while there are many different helping professions such as psychologists, clinical social workers, clinical counselors, and psychiatrists, their degree and experience is not always going to tell you how they will be in sessions.
How you connect with that person is going to tell you.
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I think every therapist brings something different to the table, just as every client does. You have every right to find a therapist that you feel comfortable with. With that in mind though, make sure that you give someone a chance, sometimes it just takes a little time for the therapeutic relationship to grow. I want to file a claim on my therapist, she makes me sick she took advantage of me and raped my soul.
How can these so called professionals get away with this behavior…??? I just feel sorry for her clients she has now…. One recommendation I would not completely agree with is the suggestion of getting a therapist referral from your medical doctor. A regular doctor, in my opinion, has more or less no special ability to make a therapist recommendation.
And — of course there are exceptions. Or see if anyone you know knows a psychologist or social worker, as these professionals know therapists and their work. While most of these seem excellent warnings, there do seem to be a number of contradictory examples, or examples that seem too vague. Therapists ought to have both the experience and the practical knowledge that allows them to move towards painful issues at a pace suitable to each individual.
But for us to judge a therapist without the same experience and training seems like it would be too easy to prevent useful therapy from occurring. I think that is somewhat true. However, it is important that as a patient, I click with the therapist. When we are pushed too far, and the therapist refuses to back down, there is a problem. The therapist who promotes their own agenda misses the cues. This could happen to any professional, but to not claim or own it is untherapeutic. All of this causes the therapy to not be effective, or AS effective, as both should want it to be.
SO both the therapist and the client should reiterate often during the course of therapy, what they understand the goal of therapy to be. The therapist should teach this to the client from the start. Therapy should help the client, know how to do therapy on themself…and eventually not need the therapist. Now, there are a group of clients whose main goal in therapy is to hear themselves validated. This, they feel, gives them the courage to continue. The energy, the esteem to face life. BUT, a therapist can not get a client to work on something, IF they do not want to do this.
A good therapist, will be aware of when this is happening to them.
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Which tends to make me suggest that a good therapist will NOT have eight hours back to back sessions during the day. Very few people can do their maximum best work, for eight hours straight. If the therapist trys to confront the client on areas the client has not agreed are areas they want to improve…this may feel like an ambush. It makes you feel a little better for the moment; BUT it does not do the prime task of therapy, which is to make you your own therapist, someone who eventually will not need another person as a crutch to cope with the world.
They are looking for a home; a surrogate parent, family or friend. A place to dock their boat when life feels stormy, and is out of control. They want a place to feel soothed, valued, and accepted. No more than you would marry the first person you dated as all dates would be equal would the first therapist you saw, have the likely hood of meeting your particular needs and style. Also, sadly, sometimes after you have been married for a while, you may have grown beyond your mate, and wish to move on. The fault here would be with the therapist, because the minute that the therapist starts feeling frustrated, the therapist should re-check to see they are going in the direction the client wants.
The therapist should help the client see what is happening in their relationship, not just leave the client wondering what IS going on. If the therapist realizes that they are not capable of helping the client grow to the level the client wants; the good therapist should offer to help the client find the person who can. Sometimes this means confronting the client, but with the VERY things the client says they want. The goals may need to be re-thought, or new goals added after this is done. BUT, know this happens in many, many cases.
It is the conflict between the conscience and the ID, and is normal. It is up to a good therapist to make this understandable and workable in therapy. One part of us believes in our changing, wants it. The other part finds it embarrassing, overwhelming, and impossible. If the therapist is relying on trust alone, and there is not enough trust established, the client may leave therapy. Everything should be with a purpose in mind, and an anticipated result. If the therapist confronted the client; the therapist should anticipate the result, AND be ready to deal with the result, they intended to create.
Before the therapist confronts, the therapist should know the client well enough to be able to anticipate the result. An exception to this would be, if the therapist has not been able to find a way into a resistant client, who may not be there voluntarily, and may use confronting as a tool to try to uncover some insight into what makes the client tick. This means, therapy is like doing a load of clothes. You have to know how much time you have not only to wash them, but to dry them.
The same is true for therapy, if you leave the client holding a bag full of bad feelings at the end of the session, the client may quit therapy. Just so, a good therapist, needs to plan the session so that if painful feelings will be experienced, the good therapist needs to make sure they will have enough time to help the client make sense of all of this and see the achievement they have made by working on the painful areas.
Same is true in therapy. You break the muscles down to a degree, in order to rebuild them. AND just like exercise there is a warm up, and a cool down period. This said, IF you have been having a GOOD and productive relationship with your therapist in general, and you have ONE or a few sessions here and there where you leave feeling not much better or even upset; the therapist may have had an off day…like us all. You will need to confront the therapist, each time this happens, and see what THEY say, then act from there if you are satisfied…or not, with their explanation.
When a therapist gets angry…or has any emotional reaction to something in therapy…a good therapist always explores what is causing this. A bad therapist will say, the client MADE me feel this way. So to have good results, you will not only need a good therapist, but a good client. When YOU have an emotional reaction to something that happened in therapy, take a look at it. Discuss it with your therapist.
See how they react. Do they help you come to terms with it, or leave you hanging. Geuss which one is a sign of a good therapist. Am I angry because someone is telling me this? Lots of people go to therapy, expecting the therapist to do the work. You face things you would rather not, you experience and re-experience hurt, shame, awful heartbreak. You have to readdress those miserable painful issues that damaged you in the first place. Some of which you did not even realize at the time were happening to you.
Generally, pain comes before change. A baby coming throught the birth cannal is not just slipping happily through. It is an exhausting, painful for both sides difficult path. You have to decide what you want, what you are willing to work for. You have to decide how much you can take, at what time. So make sure you are clear on what you are telling your therapist you want from them. Realize each therapist has different tallents, or lack of tallents. One might be intelligence. If you happen to be a gifted person, probably only another gifted person will be able to lift you beyond yourself.
It is said, that one can only truly teach to the level they have themselves reached. Consider this, all you need to get that degree is a passing grade. Some schools may pass on D students, many pass on C students.. There are only a few A students in any bunch. They show their diploma, not their grades. If you were an A student, you may need a therapist that was too.
Every body learns best in different ways. Processes information in different ways. We tend to feel best understood, and understand others that function in the manner we do. I do agree with much of what you are saying. Although grades in graduate school are not the same as in undergrad. Here is a sample of grade requirements for grad school: The unit curriculum of the MSW degree program provides the mix of academic, experiential, and research experiences essential for MSW degree students.
Students must maintain a program grade point average of 3. The minimum acceptable grade for required core courses is a B- 2. Grades in selective courses must be a minimum of a C 2. Courses with grades falling below the standards set for required and selective courses must be repeated. Students are financially responsible for the cost of repeating courses where grades obtained do not meet the minimum standards. The minimum grade in regular classes is a B-. Selective courses are courses apart from the regular curriculum of your choice.
Some professionals believe Medicare will not cover phone therapy, but they do. I just need the Medicare papers to sign. Anyone here willing? Or know of someone? Main issues: 1. Previously learned coping skills wear out fast when in this kind of life situation; would like to find some new skills to last at least few years more before having to develop another new set. Not sure how to connect to someone here if anyone is willing ; possibly the Admin could give my email address to a professional interested in working with me? She denigrates other psychologists, although not to their face.
She thinks she is the best. She is extremely convincing. Given she works with people with BPD and personality disorders her own problems should be well addressed. She never bothered getting professional supervision. Hopefully she is now. She has serious boundary issues and had a serious occurence that happened with a psychiatrist at VGH Out-Patient Psychiatry where action needed to be taken. They should. Be careful and if you think you are doing therapy with this woman, run. I feel that my therapist has judged me on my weight, being a stay at home mom, and not driving.
I always feel worse about myself after every session. She canceled three sessions in about 4 months last year; I had to wait another month after my scheduled appointment to see her again. If I wanted someone to tell me what a loser I am, I would call my mother in law. I have experienced 2 incidents that I feel hindered my therapy.
I confronted him when I realized it, but it kept surfacing during therapy and I feel contributed to the problem I had with transference because I felt violated by my therapist and kept seeing him as the person who violated me during childhood. That statement made me feel more worthless than I felt before I started therapy, and was the reason I left therapy with him, and the reason I will never have therapy again with a male therapist.
Therapist falls asleep. Therapist throws a tissue box at you, instead of offering one. Therapist laughs at what you wrote in a journal. Therapist repeatedly insists on a specific diagnosis, even when client has proof otherwise.
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When I was young, I was served liver and onions. It was absolutely horrible. I gagged and gagged while trying to eat it; tears even came to my eyes. After that terribly unsatisfying experience I did not conclude that all food is terrible and that I just could not ever eat food again. I did conclude that that particular dish did not meet my needs in any way whatsoever and that I would not be going back to liver and onions one more time. I do wish that the patients on this list and elsewhere who have had terrible, undesireable, gag-worthy, tear-provoking experiences with therapists would not blame all therapists or all therapy for their terrible experiences.
And, to be honest, I was and always have been as intimidating as the family dog. Mail the book back, or put it in a sealed manila envelope and leave it in someplace where she can pick it up, and send the therapist a note. He had TWO phones, his cell and the regular one and while we were doing the initial question and answer eval his cell phone and also the regular line rang constantly. I ignored it and kept talking, but he finished the eval and said he had been expecting an important call and would I mind if he just checked his cell phone real quick and then when he got back we could chat for awhile or I could just come back.
I said, ok, and he went and came back in like two minutes and apologized. He sat down and we talked for like 20 more minutes but the whole time the phones were absolutely ringing like mad! There needs to be some kind of work shop for therapists on abandoning a client with no resolve or closure, thats just damaging to the client. He use to encourage me to call during a crisis and we would even text back and forth and then one day he just started acting really strange towards me, saying things that would hurt my feelings, but I was never sure if he meant them that way or not and the way he terminated to therapy feels like it was more of a personal attack instead of just deciding he couldnt help anymore.
I really think he wants me to be hurt. Its really thrown me into a downward spiral and I feel like all of the progress I made has just been beaten out of me. I dont even know what I did to make him decide he hates me so much. But it makes me question therapy and it makes me leary about trying to find another therapist. I think psychologists should be aware of the impact they actually make on their clients and avoid causing them more harm. When is unilateral termination by a therapist ever ok? Any and all answers could be healing. Counsellor blames you while making excuses for your family, friends or partner.
Counsellor doubts, second-guesses and challenges your EVERY thought, opinion and course of action, regardless of its significance to your issues. Retrieval of the memories is therefore accomplished in adulthood through an altered state of consciousness such as hypnosis or age regression. A major difficulty with the idea that up to one-quarter of the women in the United States have been abused but don't remember it because they dissociated is that one would expect for the behaviors and symptoms of dissociation occurring in childhood to be observed and therefore found in the literature on psychopathology in children.
There are no data showing large numbers of children producing dissociative symptoms. Psychogenic amnesia is the dissociation mechanism postulated to explain the lack of memory for childhood abuse. Although Loewenstein broadens the definition of psychogenic amnesia to include a group of events, there is no research supporting this conception of psychogenic amnesia.
There are no empirical data supporting a concept of psychogenic amnesia for a category of events stretching across several years at different times and under different circumstances in differing environments. Also, the traditional case studies of psychogenic amnesia in the literature indicate that such persons have undergone severe life stresses, such as violent physical abuse, torture, confinement in concentration camps, or combat. In such cases, the events should be able to be independently verified since without verification that an event has, in fact, occurred, one cannot talk about amnesia for the event.
However, corroboration by parents, siblings, or others seldom occurs in recovered memory cases. Most people experiencing trauma do not develop amnesia for the trauma. Case studies on the reactions of people to documented severe trauma, such as fires, airplane crashes, automobile accidents, and being held hostage show many symptoms but total amnesia for the event is not mentioned as a common response Spiegel, Terr's , , research with children who have experienced documented trauma indicates that children over the ages of 3 or 4 do not develop amnesia for the trauma.
All of the children in this age group had full verbal recall or extensive spot memories, although the memories may have been inaccurate or fragmented. Although they may have denied parts of the aftermath and the effect on them, they did not deny the event. This is consistent with Malmquist who reports that in a study on children who had seen a parent murdered, not one child age 5 to 10 years "repressed" the memory.
Children under 3 or 4 are unlikely to remember the trauma because of their age, but this is not psychogenic amnesia or repression. Such forgetting is due to the phenomenon of infantile or childhood amnesia. This inability to recall events from an early age is a function of the normal process of growth and development. Infantile amnesia may even encompass a larger age span. Wetzler and Sweeney , in a review of research investigating childhood of infantile amnesia, report that research shows fewer memories than would be expected through the normal forgetting function under age 5 and they therefore believe that childhood amnesia begins below age 5.
The phenomenon of infantile or childhood amnesia also means that claims of recovered memories from a very early age are suspect. In recovered memory cases, this diagnosis is used to explain the lack of memories for the event. According to the DSM-III-R American Psychiatric Association, , the PTSD diagnosis is given when an individual develops characteristic symptoms after experiencing an extremely distressing and traumatic event that is outside the range of usual human experience.
This event is usually experienced with intense fear, terror, and helplessness. The symptoms involve reexperiencing the traumatic event, avoidance of stimuli associated with the event or numbing of general responsiveness, and increased arousal. However, although the criteria for PTSD mention numbing and efforts to avoid thoughts or feelings along with psychogenic amnesia for an important aspect of the event, there is no mention of total amnesia for the whole event.
Also, in order to diagnose PTSD, there must be a known stressful event. The diagnosis cannot be given on the basis of the symptoms alone without verification of the event. Multiple Personality Disorder Multiple personality disorder is often suggested in recovered memory cases, especially when the alleged abuse is violent and sadistic. The disorder is believed to begin early in life and most people with this diagnosis are women. A "protector" personality is believed to emerge and take over for the individual, who therefore escapes psychologically from the abuse Spiegel, However, support for this theory is based only on clinical case reports and in a recent review of the empirical literature on the long-term effects of child sexual abuse, Beitchman, Zucker, Hood, daCosta, and Akman concluded that as yet there is insufficient evidence to confirm a relationship between childhood sexual abuse and multiple personality disorder.
A few therapists are seeing most of the MPD cases, and the majority of them are in the United States. There is little empirical evidence supporting MPD and it is heavily dependent upon cultural influences for both its emergence and its diagnosis. They have conducted an extensive series of experiments to demonstrate this.
Therapy For Uncovering Memories The questionnaires in the FMS project described above indicates that the recovered memory almost always first surfaces in therapy. What takes place in such therapy? Descriptions of the type of treatment offered are found in the writings and workshop presentations of therapists as well as in the anecdotal reports from women who have undergone such treatment. We found no outcome data in the descriptions of these programs. There is no information given on validity or reliability of the techniques used. Treatment programs use a variety of techniques to help patients recover memories of sexual abuse.
These include direct questioning, hypnosis, reading books, attending survivors' groups, age regression, and dream analysis. In the questionnaire, respondents also reported a variety of unconventional techniques including prayer, meditation, age regression, neurolinguistic programming, reflexology, channeling, psychodrama, casting out demons, yoga, trance writing, and primal scream therapy. The first goal of treatment is to work on memory retrieval.
After the woman can develop memories of the abuse and talk about what happened, she is encouraged to express her rage by throwing darts at pictures of the perpetrator and writing him angry letters. Her feelings of shame are dealt with through art and music, and by taking bubble baths to eliminate dirty feelings. Courtois discusses how to bring about the retrieval of memories. The assumption is that events can be perceived and stored by a preverbal child, that visual or imaginal and other sensory cues can stimulate the retrieval of these memories, and that since abuse memories were stored during experiences that produced arousal and helplessness, the client may have to reexperience painful emotion in order to remember.
Triggers for recall include developmental events or crises; events that symbolize the original trauma; crises associated with recollection, disclosure, confrontation, reporting, and criminal justice; issues in therapy; and life states or events. Survivors' groups and self-help groups can help stimulate memories.
Techniques used to retrieve the memories include hypnosis, guided imagery, writing an autobiography, drawing, guided movement, body work, psychodrama, making a family genogram, drawing the floor plan of the childhood home, and bringing in family pictures and childhood memorabilia such as toys, report cards, and diaries.
The memories may return either overtly or in symbolic form such as flashbacks, body memories, and nightmares and dreams. Courtois maintains that a strong alliance between therapist and survivor is necessary for memory work. The therapist should be calm, accepting, reassuring, encouraging, and validating of the disclosures. Although she cautions against the therapist conclusively informing the patient that the abuse happened, Courtois says that it may be necessary for the therapist to speculate about it to the client.
Courtois believes that memory can return physiologically, through body memories and perceptions. The body memory concept assumes that if abuse occurs when the individual is too young to recall, although the mind may not remember the event, the body is able to. Courtois therefore asserts that the survivor may retrieve colors, hear sounds, experience smells, odors and taste sensations, and her body may react in pain reminiscent of the abuse and develop physical stigmata as the memory is retrieved. Fredrickson believes that repressed memories of abuse stalk the individual's life but have been held in storage until the person is strong enough to face them.
She differentiates between five types of memories: ordinary memories, or "recall" memories, "imagistic" memories memories that break though the conscious mind with images like a slide show , "feeling" memories memories that are the feelings that something abusive has happened without the actual memory , "body" memories the physical manifestation of abuse-"Our physical bodies always remember sexual abuse. Fredrickson maintains that the "journey" towards retrieving these memories is necessary for recovery, serenity, and even survival. Since few survivors experience spontaneous recall, various memory retrieval techniques are necessary.
She recommends dream interpretation, free association writing, massage therapy, body manipulation, hypnosis, feelings work, art therapy, and expanding on imagistic memories. Dolan recommends hypnosis, ideomotor signaling with the unconscious, age regression, and automatic writing as aids to memory retrieval. She also describes a variety of techniques for "facilitating integration of recently retrieved memories These include making and carrying around an Indian "medicine bundle" composed of symbolic articles and written words evocative of the client's healing resources, holding an imaginary funeral for the family of origin, burying pictures of the family, having a divorce ceremony from the family member s , doing "bodywork," producing art projects such as face masks, collages, and Amish quilts, taking herb-scented bubble baths and buying flowers, writing down feelings and then burning the paper, tape recording expressions of anger, making a tape to the inner child and then burying the tape in the childhood yard, and nurturing the inner child by buying a cuddly teddy bear or rag doll, eating ice cream, and getting a puppy.
They see the role of the therapist as helping the patient become convinced of the historical reality of the abuse, even when there is no external corroboration and even when the patient herself doubts that the memory is real. The therapist is identified as the one person in the patient's life who "really sees the truth. Body memories, dream analysis, and analysis of transference are used both to retrieve the memories and to provide "validation" of the historical reality.
The therapist should not be limited by the fact that the historical truth cannot be verified. An illustration of a network actively engaged in recovering memories is Three in One Concepts, an organization begun and headed by a Gordon Stokes who claims a clinical background in behavioral genetics, psychodrama, and role play training David, Stokes claims to have taken specialized kinesiology into new avenues of self-discovery.
There are said to be at least facilitators of this new specialized kinesiology and seminars in this approach are offered all over the world. The technique is to have the individuals extend their arms, then ask them questions and press on their arms. The body, through the unconscious, answers the questions. If the arms stay rigid, that means yes. If the arms fall back, that is a no answer David, When the calls came in from Provo, Utah, several of the persons described their experience in therapy that led to the development of putative memories as precisely this procedure.
This book contains statements such as: "If you are unable to remember any specific instances Many women don't have memories, and some never get memories. This doesn't mean they weren't abused" p. Demands for details or corroboration are seen as unreasonable: "You are not responsible for proving that you were abused" p. The book encourages revenge, anger, fantasies of murder or castration, and deathbed confrontations.
The veracity of the recovered memories is never questioned-one section uncritically presents an account of ritual abuse by a satanic cult of town leaders and church officials that included sexual abuse, murder, pornography, drugs, electric shock, and forcible impregnation of breeders to produce babies for sacrifice. In the survey project, a majority of the respondents who had some knowledge of the type of therapy reported that hypnosis was used.
However, the use of hypnosis for memory retrieval raises serious questions about the accuracy of the recovered memories. Under hypnosis, people are more suggestible and are therefore more likely to agree with a persuasive communication. But there are serious problems with the accuracy and validity of memories that are recovered through hypnosis. However, the individual is apt to experience these memories, which can be quite vivid and detailed, as subjectively real. This increases subjective confidence in the reality of the memories. Therefore the individual appears confident and certain about the memories, and can be persuasive and convincing when talking about them.
Ganaway notes that memories retrieved in a hypnotic trance are likely to contain a combination of both fact and fantasy in a mixture that cannot be accurately determined without external corroboration. Since hypnosis increases confidence in the veracity of both correct and incorrect recalled material, the therapist should be very cautious about reinforcing the truthfulness of any memories which are elicited through hypnosis unless there is outside corroboration.
Individuals are frequently referred to a survivors' therapy groups or self-help groups such as those for adult children of alcoholics. Such groups are apt to give continual encouragement for uncovering memories of increasingly intrusive and deviant abuse. Herman and Schatzow report that their survivor therapy group "proved to be a powerful stimulus for recovery of previously repressed traumatic memories" p.
Price describes the suggestibility and group influence where, after one woman would suddenly recall a new abusive event, others would soon recall similar events. Since the norm is that group members were abused whether or not they remember it, and the task of therapy is to uncover the hidden memories, group members are given attention, encouragement, and reinforcement as they uncover and report their repressed memories.
In fact, Campbell observes that given the process of conformity and compliance that will characterize any group, clients in such a group who deny a history of sexual abuse run the risk of being ostracized as denying deviants. The FMS Foundation is aware of more than cases in which survivors are at some stage of suing based on the recovery of "repressed memories. Satanic Ritual Abuse Memories uncovered in therapy often grow and develop until they include satanic, ritualistic abuse. The recovered memory questionnaire project found that one-fifth of the respondents reported ritual abuse.
Preliminary data from a survey by the The American Bar Association indicates that about one-third of local prosecutors have handled cases involving "ritualistic or satanic abuse" Victor, a, b.
A few therapists seem to be finding almost all of the survivors, who are often diagnosed as multiple personality disorder. Shafer and Cozolino in a study of 20 adult outpatients who reported such abuse, note that these individuals did not seek therapy because of awareness of abuse.
Instead they entered treatment for symptoms of severe depression, anxiety, or dissociation. However, once in therapy, the uncovering of memories became the primary focus. The subjects often participated in step programs and incest survivor support groups which became substitute families for the subjects who had cut ties with their biological families.
Shafer and Cozolino maintain that these retrieved "memories" are of historically real events. Gould and Cozolino believe that since psychotherapy is the only way for the victim to escape the cult, the cults interrupt the therapeutic process through programming alter personalities to disrupt treatment. These alters are programmed to stay in regular telephone contact with the cult, to engage in self-injury, to scramble the message received by the patient, and to respond to messages from the cult, such as hand signals, taps on the window, or a word or phrase.
The individual must therefore be helped to recall all of the components of the abuse in order to identify and understand all of the alters, who will then no longer be compelled to obey the programming instructions from the cult. A therapeutic alliance should be established with the satanic alters and the therapist should resist impulses to exorcise them. Young, Sachs, Braun, and Watkins report on 37 alleged satanic cult survivors found among dissociative disorder patients.
These people entered therapy with problems of severe impairment in functioning along with anxiety and depression. Typically they had some memories of abuse but had nearly complete amnesia for the childhood ritual abuse. The ritual abuse memories emerged during the course of treatment. Eventually most of the patients reported memories of satanic ritual abuse, including sexual abuse, physical abuse, torture, death threats, animal mutilation, infant sacrifice, cannibalism, marriage to satan, being buried alive in coffins and graves, and forced impregnation and sacrifice of their own child.
Mulhern notes that all 37 patients reported by Young, et al. Their reports of ritual abuse are basically rarefied memory narratives assembled in therapy over time out of bits of images and affect which emerged when the patients were abreacting, dreaming, experiencing flashbacks, experiencing dissociated states, or responding to explicit questioning during hypnotic interviews. The allegations in survivors' accounts have not been independently verified. However, this knowledge does not dissuade the therapists who believe in their existence.
Case Examples of Therapy Experiences Information from two women who underwent therapy experiences such as those that are reported above are included in this issue of the journal Gavigan, ; Gondolf, These accounts give vivid details not only of the techniques and procedures used but of the harmfulness of such a "treatment" experience. Both women entered therapy for problems other than sexual abuse-one woman for depression and the other for an eating disorder.
But both were questioned extensively from the beginning about abuse. Both were given a variety of medications, encouraged to confront their parents, read survivors books, and participated in group therapy where the group norm was talking about the abuse. Both were encouraged to remember more and more about the alleged abuse and eventually both developed graphic and detailed stories involving violent, sadistic ritual abuse.
Both women clearly became worse as a result of therapy. One instigated a civil lawsuit against her father. Both also are intelligent and courageous women who are not only able to understand how the therapy process led them to develop the false memories, but are willing to talk about their experiences in the hope that this will provide information helpful in understanding the recovered memory phenomenon.
Dance/Movement Therapy with Refugees and Survivors
In a participant observer study, Nathan immersed herself in the incest survivors' movement, including attending a marathon retreat for survivors of incest. There were six therapists for three dozen women survivors, who clutched stuffed animals and began the retreat in a room furnished only with mattresses. Rage at the perpetrators was expressed by the women's "inner children" through beating telephone books with rubber hoses while squatting over the mattresses and screaming obscenities. Eleven of the women had no abuse memories but were told to participate in the activities. The participants were encouraged to give detailed descriptions about their abuse in the group setting because hearing the others' stories might help trigger memories.
When one woman, recalling memories of cult abuse by her mother, sobbed and said she didn't know if the memories were really true, the therapist told her she had to face the memories and ordered her to do mattress work, "Now! The only kind of victims with status among the women and therapists were the women who had suffered rape, torture, and black robes.
Others who only reported emotional abuse or battering or couldn't remember the abuse had no status in the "swimsuit competition atmosphere" of the retreat. Loftus reports on a situation where, after he was accused by his adult daughter, a father hired a private investigator who went to the daughter's therapist complaining of nightmares and trouble sleeping. On the third visit, the therapist told the pseudo-patient that she was certain the woman was experiencing body memories from a trauma, earlier in life, that she could not remember.
The pseudo-patient said she didn't remember any trauma. The therapist said this was the case for many people and told her to read The Courage to Heal. The therapist then read from the long list of symptoms from Blume's book, Secret Survivors. During this, for two-thirds of the symptoms, the therapist looked at the pseudo-patient and nodded her head as though this was confirming the diagnosis.
The therapist then recommended the woman attend an incest survivors group. By the fourth session, the diagnosis of probable incest victim was confirmed based on the symptoms of body memories and sleep disorders, even though the pseudo-patient insisted she had no memory of such events Not to be Fooled and Not to Fool A common factor in the academic experience both of us had, one at the University of Minnesota and one at University of Maryland, was a general skepticism and a respect for science.
The passion not to be fooled and not to fool anybody else is not as much in evidence in psychology as it once was but we still maintain that one attribute of a competent psychologist is the ability to evaluate critically the nature or state of the scientific evidence that can be mustered to support an opinion, a view, or a diagnosis. Especially for clinical psychologists there appears to be a mistaken readiness to rely upon clinical experience, even one's own idiosyncratic experience, as a reliable and valid source of truth.
It is true that in a clinical setting hard data may be difficult to come by and the clinician is always operating with incomplete data. Nevertheless, it has ethical implications if the clinician uses a diagnostic procedure which has been shown to have negative validity to make life and death decisions about people and their families that may have far reaching destructive consequences.
The ethical issues are sharpened if the clinician takes the patient's or the taxpayers' money for a procedure with a high probability of fooling both the clinician and the patient. This is totally different than choosing to act when there is a pragmatic reality. To know that a procedure does not predict anything and produces large numbers of false positives and erroneous diagnoses and to continue to use it is not just foolish, it is unethical. The therapists who are committed to retrieving recovered repressed memories of childhood sexual abuse argue that it is a therapeutic necessity to believe the patient even if the memories cannot be verified and even if they are not historically accurate.
They claim that it has therapeutic benefit and helps the person when the therapist believes their story. But there are no quantified data that can support that claim but only assertions of clinical impressions. This foolish idea rests upon the assumption that error can be beneficial. Error can never contribute to healing nor to a better life. Anyone familiar with the history of medicine can see that it is not enough to be a compassionate, empathic, warm, even bright person, who wants to help people who are hurting.
This is the error that led to medical practices such as performing bleeding which killed George Washington , using insulin shock therapy, pulling out teeth to treat schizophrenia, performing frontal lobotomies, or putting premature babies in an oxygen-enriched environment which sometimes blinded them. Most recently, breast mastectomies and heart bypass surgery have been shown often to be ineffective and unnecessary. The competent psychologist can make the discrimination between explanations that have some support for accuracy and myths or dogmas that do not Meehl, , Making an accurate determination of claims of recovered memory involves a probability assessment by the clinician.
The inference goes from behavior of the rememberer seen on the outside at the present and guessing about an unobservable inner state, including complex internal dynamics enduring across long periods of time to an unobserved and largely uncorroborated prior event. The less that is known about any of the multitudinous entities, intervening variables, the many layers of interactions, and the antecedent probability of all postulated phenomena, the greater the likelihood of errors. The psychologist who clings to presumed knowledge with no evidence of validity or reliability but rather a high probability of error is no better than the witch doctor, the astrologer, and the palmist who may fit in on the carnival midway but has no place in a venture calling itself science or claiming to heal.
Claimed Support for Repressed Abuse and Recovered Memories in the Literature There are a few studies claiming support for the concept of repressed abuse and validation of the historical reality of recovered memories. These are cited frequently by the believers as evidence that the concepts have been empirically validated. But these studies must be read very carefully since there are serious problems in terms of what they purport to demonstrate. It is difficult to get information about how abuse was verified.
Rich notes that when he has asked for verification of self-reported childhood abuse, the "confirmation" often consisted of sketchy hearsay information from other family members, apparently reported by the woman herself during therapy. The two articles most often referred to are by Briere and Conte and Herman and Schatzow However, they only asked one question to investigate this: "During the period of time before the first forced sexual experienced sic happened and your eighteenth birthday was there ever a time when you could not remember the forced sexual experience?
It could be interpreted to mean just not thinking about the abuse for days or months, to mean forgetting about it until reminded somehow, or perhaps, to mean consciously determining not to think about it. Also, some subjects might interpret the question to include a period of time before the abuse occurred, as the question literally asks. But Briere and Conte conclude from their study that "repression partial or otherwise appears to be a common phenomenon among clinical sexual abuse survivors" p.
There is no distinction made between simple forgetting which psychology has known about since Wundt's first laboratory and repression. They simply assume their single highly confusing question measures the postulated complex process of repression. They then assert that "some significant proportion" of psychotherapy clients who deny a history of sexual abuse have, nevertheless, been abused. Nowhere in their report, however, is there any information concerning verification of the claimed abuse. It is simply assumed that a client who recovers the memory under the guidance of a therapist is reporting an actual event.
At no point do they address the issue of the generalizibility from their sample of patients recruited by therapists and the demand characteristics of being patients in a network of sex-abuse therapists. At best this study may provide a base for hypotheses to be tested by further research but it cannot be advanced as establishing the reality of a process of repression of memories of sexual abuse. Herman and Schatzow report on their experience with a therapy group for incest survivors and maintain that three out of four of 53 women in the group were able to "validate their memories by obtaining corroborating evidence from other sources" p.
However, most of their sample was of women who had either full or partial recall of the abuse prior to therapy; only one-fourth 14 had no recall before entering the survivors' group. But in discussing the claimed corroboration, no distinction is made between women who had always remembered the abuse and those who didn't recall it until entering therapy. In addition, the "corroboration" is not convincing. The details of the corroboration are vague and depended upon the reports of the women in group therapy.
Out of the four case examples the authors present to describe the verification process, in only two did the woman have complete amnesia for the abuse prior to therapy. For one of these, there was no corroboration of the abuse. For the other, the corroboration consisted of the women's report in group therapy of discovering her brother's pornography collection and diary after he was killed in Vietnam. But there is no indication that anyone else saw the diary or verified what the woman claimed she found. Young, et al. However, all of the alleged corroborative findings are completely nonspecific and cannot be said to provide verification.
The "corroboration" consisted of physical findings such as scars on the back, a distorted nipple, a "satanic tattoo" on the scalp and a breast scar on one patient. But there is no information of detailed medical workups or photographs of these alleged physical markings. Other evidence of physical findings included three women with endometriosis diagnosed before age 16, one with pelvic inflammatory disease at age 15, and one whose school performance dropped from age 7 to 10 during the years she supposedly was in the cult until the family moved.