In Which Jamie Chooses a Bizarre Topic for Considering the Conflict Between Fidelity to Our Clients and Fidelity to Truth (which he doesn’t Really believe in either)

This is post number five, and it about imaginary devil worship. Number four was about Public Enemy and my contrary ways. Number three was about the blues, number two was about feorabros, and number one was about Scandinavian heavy metal.

Doherty’s book, in his chapter about prudence, makes an interesting detour when covering the consequences of not knowing epidemiology. He says that a shortcoming in the therapeutic world is that we are not very attuned to big contexts when we diagnose, and because we are not cognizant of the frequency of certain problems we are not aware of how likely they may be. We might be likely to recognize a zebra when we should be looking at a horse. Horses, on this continent, are fairly mundane. There are a lot of horses around. Not so many zebras. 

He says that one of the reasons we tend to do this is that we look at clients individually without an epidemiological perspective. An extended example he gives is the then recent (the book was first published in 1995) phenomenon of Satanic ritual abuse, when thousands of people had “recovered memories” of being forced to participate in elaborate rituals involving sexually abuse, torture, and human sacrifice.  Of course, “Satanic ritual abuse” narratives, which included descriptions of demons and monsters, were nonsense. It was, in fact, dangerous nonsense that sent several people to prison and caused serious harm to patients who became convinced that their elaborate fantasies were real memories.

One of the victims of the broader “Satanic panic” of the 80s and early 90s was Damian Echols, a teenager from Arkansas who spent decades in prison (he is now free) for the “occult murder” (there is no evidence that there was anything about the murder to do with the occult and nothing connecting Echols or his two co-defendants to the crime) of two young boys. His conviction was based on the fact that he wore black clothes and put off “creepy vibe.” Echols, along with two young men who were convicted of the crime, became something of a famous cause after a documentary called “Paradise Lost” was released in 1996.

Below is a link to an article about the ongoing problems that Damian Echols has faced, even after being released from prison:

 http://www.esquire.com/news-politics/news/a29142/witch-hunt-in-salem/
  

Doherty, when taking about Satanic ritual abuse, writes that some therapists struggled to deal responsibly with their clients because they did not want to disrespect their client’s perspective:

“Some therapists respond to this argument by saying that their responsibility is not to judge the accuracy of Satanic abuse memories but merely to accept the reality of clients’ memories. On the face of it, this sounds like the same approach I endorse for familial sexual abuse victims: do not get into juridical evaluations of evidence but accept the clients’ subjective experience of familial abuse.” (pg. 171)

I tend to be on the post-modern side of things, particularly epistemologically, and so I can see a case for respecting a client’s perspective, regardless of whether I think it is the most faithful to the facts of a given case. That does not mean that I think it okay to pretend that someone’s memories of eating babies or being molested by Satan are to be taken at face value, particularly when those memories were a part of a moral panic that seriously hurt people.

That is an extreme, and now that it is removed in time, somewhat whacky case, but do we not constantly encounter information from our clients that we, because of our training, our life experience, and our common sense, might doubt? What criteria do we use to decide what to do with these encounters? In the case Doherty describes, epidemiology (and common sense) make it easy to make judgments about when to believe a client and when not to do so. Sexual abuse, in its everyday, unglamorous reality, is real and common. We should discount stories about it unless we have very good reason. Elaborate Satanic conspiracies, on the other hand, would necessarily be very rare.  

Our dilemmas will not be so clear cut. Is this client lying about substance abuse? Are they misrepresenting their history to protect themselves? Are they giving us selective information? We can make good guesses sometimes based on what we know about behavior and based on reason, but then what? Do we risk the therapeutic alliance to challenge a client? Do we accept their perspective and move forward? After only a month working as an apprentice therapist, I am already encountering these questions almost daily. What to do with them, I do not know.

(It is worth noting that some of the origins of the “Satanic ritual abuse” phenomenon were therapists using techniques that helped to create memories of abuse. This throws something of a monkeywrench into my post, as doing very harmful therapy presents no ethical dilemma at all, and it not the same thing as believing a client’s perspective. Doherty’s more charitable version of the story presents a more relevant ethical case, so I will go with that.)

I Still Got Them Late Capitalist Nationalism Blues And So Forth

This is post number four. Number three was about the blue, number two was about feorabros, and number one was about Scandinavian heavy metal

I continue to enjoy these books as a dialogue, particularly because each of them individually does not quite hit the mark for me. The big theses of each is strong, and these were excellent choice for the class to read, but I keep raising my eyebrows at some of the underlying perspectives in the books. I think some of my reticence is my background in cultural studies. I am used to framing things in a political-social-justice-type way, and these books are from different places than that. The moralistic slant Hollis takes is convincing, but the observations he makes are often pretty mundane. I am quite familiar with the idea that “evil” is banal and that patriotism has a nasty underside and so on. Got it. I agree. Let’s talk about history now. Similarly, even though the central argument of the Doherty book, that psychotherapy should have a moral perspective, is a lot more challenging, the liberal point of view that Doherty puts forward is not particularly thoughtful.

(Since everyone might not be familiar with “cultural studies,” I want to clarify that that phrase does not mean to study cultures. It means to apply Marxist thinking  and other critical points of view. . . like Foucault, who we read about. . .  to texts.)

The weaknesses that each book has individually are not a big issue for me, however, as the two books complement each other in a lot of interesting ways. My post last week was about the lack of community that many Americans feel and the psychic costs of that isolation. When skimming back through Hollis this week, I ran across a wonderful “on the other hand” moment. One of Hollis’s big themes is the ways that ideology can be insidious and evil, and his seventh chapter, about “the corporate Shadow” is narrowly focused on that issue. After laying out a long list of nasty things Americans have done, Hollis comments:

“Are these examples not a corporate Shadow, the darker hue of a self-congratulatory people who quickly extol their virtues and good intentions? Are we not reminded of Emerson’s observation that what we do speaks much louder than what we say? Is it not true that corporate life, no matter how noble its intention, is forever being brought back to the lowest common denominator?” (pg. 130)

This perspective, that ultimately the United States is a violent “lowest common denominator," brought to mind some of the very public controversies associated with hip hop in the late 80s and early 90s. These controversies happened just as I was just getting old enough to pay attention to pop music in a serious way, and while some of the misogyny, nihilism, homophobia and racism in some of those controversial records has not aged well, the larger point that they made, that the “good America” is a lie, or at least a very selective picture, is one that stuck with me. 

 https://www.youtube.com/watch?v=8PaoLy7PHwk

When we talk to our clients, the kind of blunt confrontation that I like so much in Public Enemy’s music is, of course, inappropriate, of course. (Of course.) But their thesis, that the game is rigged and we should be angry about it, is one that we should take to heart. We often talk about diversity issues as challenges in joining with clients, but we should not lose sight of the ways that the ugly history of (while we are working here) Central Georgia is a part of the challenges our clients face. We cannot downplay the responsibility and agency that we mean to foster, but we also cannot forget that we all, whether we have experienced or perpetrated violence, live with a violent collective history.

In some ways this post is as reprisal of my first post, which was about my comfort with some of the darker kind of artistic expressions that humans have contrived, and my discomfort with patriotism. I will work to avoid rehashing the same ideas over and over (and I hope I have not done that in this post), but that perspective, which is very different from where most people are seeing the world, is a big part of who I am.

My challenge as someone growing into being therapist is to develop that worldview into moral perspective that can serve my clients. I would not recommend blasphemous metal records to my clients, but I will take into the room my respect for questioning everyday assumptions. In some ways, I am simply trying to embrace the kind of stances that postmodern and feminist therapists have advocated, but I am me, and my own experience and coping mechanisms, which include not so conventionally “positive” strategies like dismissive anger and gallows humor, are what I am. How to build a bridge between who I am and what I am learning to be is my challenge.  

P.S. I am very uncomfortable with patriotism, but I love college football. Go figure. Also, go dawgs.

Got Them Atomized Society Blues Again

This is post number three. Number two was about feorabros and number one was about Scandinavian heavy metal

One of the stronger features of Doherty’s book is that he clearly articulates a liberal moral perspective. 

Now, before people misread that sentence, let me clarify what I mean by a “liberal moral perspective” and why I think that it is a good thing for Doherty to endorse such a point of view. By “liberal,” I do not mean the partisan political project— these days in the United States we mean Democrats-- but the tradition of citizenship and social responsibility that is a core part of democratic life. As a left leaning person, I have reservations about liberalism, but it does provide us with a useful, if problematically uncritical, way to think about how people are connected to communities. And as systems theory oriented therapists, we’d better damn well care about encouraging people to find meaningful ways to participate in their communities, and one could do worse than choosing liberalism as a way to talk about what that participation looks like. (People use “left” and “liberal interchangeably. That is an asinine thing to do. If you want to see a lot of liberal bashing, get to know some lefties. I do not mean anything politically partisan in this paragraph.)

I like the section on pg. 94-96 where Doherty talks about “civil society,” its erosion, and the psychic consequences. The following passage is particularly strong, and particularly troubling:

“The civil society is where individuals find their deepest sense of connection and where individuals find their deepest sense of connection and where the social construction of morality occurs in everyday life. What we think of as strong communities have rich layers of private voluntary organizations and associations that counterbalance the profit motive of the market and the bureaucratic legalisms of the government. However, the strength of the civil society (especially in the United States) is receding rapidly before the forces of the market and the state. In many ways the breakdown of community in the United States and in the Western world is the breakdown of civil society” (pg. 95).

Doherty goes on to discuss the psychological consequences of the increasingly atomized lives that Americans live. It is a half century old cliché to talk about the “alienation of suburbia” or loss of community” as major themes of 20^th Century American Life, and these are the major themes of a lot of great, and plenty of not so great, 20^th Century American art. We are all perfectly familiar with what Doherty is talking about here.

It is still worth thinking about. One corner of American art that is particularly interested in alienation and dislocation is the blues. Of course, blues music is generally funny and celebratory, but much of the good cheer is black humor. (People who thing the blues is supposed to be sad do not listen to much of it.)

Of course “the blues” is a style of music, and a euphemism for depression. It is noteworthy that so much of the work done in a genre of music named after mental disorder is focused on traveling and dislocation. Of course, the people who created the blues were talking about the dislocations of traveling to look for work or traveling as a part of the life of a professional musician, and the blues, as serious as the themes are, has a romantic patina.

 https://www.youtube.com/watch?v=R7NfJL5lbIk

About the above video: where’s he walking TO, exactly? Dude. Where you goin? Seriously, man.

The characters created in blues songs are often apart from community because they are willful dissidents or outlaws, or because they are living an adventurous life. The people we will see in our therapy rooms are apart from community because no community has been offered them or because their connections to community have collapsed. One of the strong points of Doherty’s book is that he begins to give us a framework to understanding ourselves as a part of a larger moment in history, where the alienation that was once the experience of outsiders, voluntary or not, has become banal. As therapists, we need to work to orient ourselves to the reality that he describes. Our ethical responsibilities depend on working to make sense of the diverse ways that our clients might experience this reality.

Margaret Thatcher famously said “there is no such thing as society” as a preface for some blather about families. That wasn’t quite the case, but she captured a bit of the zeitgeist in that statement. Would that she were compassionate enough to see the darkness in it.