Non-Biased Therapists?
by Dr. John Riolo
Well, Garry, a while ago we debated whether or not it was possible for political conservatives to find a non-biased therapist since we as a group tend to be disproportionately skewed to the left of center politically. I’m afraid it’s even worse than I thought. Politics seems to be pervading almost all our clinical thinking these days and I don’t think either our liberal or conservative clients benefits from this. And it makes us look foolish.
Let me give a couple of examples. Most of us by now have heard of the horrible tragedy of the mentally ill fellow who was shot by air marshals at an airport because he held on to a bag and allegedly said it was a bomb. It was a horrible tragedy made worse by some of our colleagues' Monday morning quarterbacking. He refused to drop the bag and was killed. Why didn’t they shoot for the hands or legs, some of our colleagues lamented. Shooting him in the hands! I know I have said some of our colleagues are stuck in a time warp of the 60s, but some seem to be back in the 50s when we watched Hopalong Cassidy or the Lone Ranger on TV shoot the gun out of the bad guy’s hand and there was never any blood. Great children’s TV, but in real life that kind of marksmanship is close to impossible. But of course people who have never shot a gun suddenly are experts in law enforcement and marksmanship. BTW if someone has their hand on explosives do we really want the air marshals to be aiming for the explosives? Do we?
What about Tazers and stun guns, some might ask? Well, that’s more plausible but to disable someone with these devices you have to get up close, real close. If US policy dictated that only non lethal means be used, then every time someone threatened to have a bomb, it sure would give real terrorists an advantage. Further, if the terrorists had an accomplice to claim they had some DSM disorder so you can’t shoot, that would be an added advantage. I suppose one can argue that anyone willing to blow themselves and any number of others up must have some DSM disorder, but that does not help us much once the bomb's detonated and the shrapnel's flying.
In order for air marshals to distinguish the truly mental ill or the non dangerous mentally ill from the murdering thugs who like to blow up people, they would need to do an assessment in seconds that many of us could not accomplish in several sessions. So the ramifications of that ill-advised policy would be that airport security would need to check our mental health history before we obtained our airline tickets or got anywhere near an airport. The technology to review anyone’s health and mental health history is available today. But do we really want to do that?
Another example is PTSD or Post Traumatic Stress Disorder. As group therapists have a vested interest in seeing PTSD, which once fit only a minority of military veterans, grow to fit any number of conditions. In a recent Washington Post article, Harvard psychologist Richard J. McNally argues that the diagnosis equates sexual abuse, car accidents and concentration camps, when they are entirely different experiences: A PTSD diagnosis has become "a way of moral claims-making," he said. "To underscore the reprehensibility of the perpetrator, we say someone has been through a traumatic event."
So if we combine our tendency to diagnose almost anything that moves with PTSD, which can now include people who have been in fender benders, with our general dislike for wars, conservatives in general and this administration in particular, we get an interesting turn of events.
We are increasingly using or attempting to use our professional knowledge to try to make political points and serve our political agenda. It becomes a pro-war-versus-antiwar issue. If we can claim that PTSD is so prevalent and so severe in the armed forces serving in Iraq and Afghanistan, it becomes a reason why we should stop that war. On the other hand if actual PTSD rates are or no higher or lower than in other armed conflicts, we have to oppose the war on grounds that have little to do with the mental health of military personnel, and our arguments have nothing to do with our expertise or training. We are simply arguing as any citizen with no more or no less expertise that any other.
Perhaps it would be better if we just kept to our areas of expertise and when we venture into politics it should only be with a disclaimer that we no more know what we are talking about than anyone else.
It’s perfectly fine to be outraged by our Homeland Security Policies. I am. It's fine to express our opposition the war. I am not in favor if it myself. However it is quite disingenuous to claim that our political views are informed by our special expertise as mental health experts and that this makes us more informed than any anyone else about politics. I am also disturbed by the tendency among mental health professionals to categorize anyone who sees things differently in a negative light. Garry, you and I have seen and heard many times our colleagues categorize people who hold different positions as ignorant or suffering from some disorder. Why can’t we just agree to disagree like civilized people?
One last note Garry, you say I often take comments from a listserv of therapists, and listservs are notoriously places where people let their hair down and dash off all kinds of emotional and often poorly reasoned emails. Well that’s true, I suppose. But where we disagree is that you seem to think it's not a good indicator of how these therapists truly think or more importantly how they might actually practice behind closed doors with their patients. I think it's an excellent indicator, perhaps one of the best there is. True we all have made a fool of our selves saying something stupid at one time or another on a listserv. I have. But it’s not the occasional foolish or outlandish remark that concerns me. Over time one can see patterns and ways of thinking that permeate. How a therapist’s politics and political views influence their professional judgment can be apparent over time in their writing. In some cases it is obvious to anyone except the person him or her self. I suppose one might call it an equivalent of the Rorschach Test. If you believe one can learn useful information about someone by their reactions to ink blots, how much more cam be learned by actual comments to their peers?
John Riolo is a psychotherapist, Vice-President of Psychjourney and consumer advocate. He is known as the Insider and sometimes known as the therapist other therapists love to hate. His website Your Advocate Online includes many articles and audio interviews addressing the inner trade secrets of psychotherapy. Listen to his new Internet radio show, The Insider. Contact him at johnr@psychjourney.com