Wednesday, January 31, 2007

 
from the People Who Should Be Hit In The Head With The DSM-IV Dept:

courtesy of the fine folks at Yahoo News:

SYDNEY, Jan 30 (Reuters Life!) - An Australian psychologist charged with indecently assaulting a patient told a court on Tuesday that forcing his female patient to wear a dog collar and call him master was within a psychologist's ethical guidelines.

Psychologist Bruce Beaton, 64, pleaded not guilty in the Western Australia District Court to four charges of indecently assaulting a 22-year-old woman in 2005, local media reported.

Beaton was arrested when police, who had been secretly video recording the session with the woman, heard whipping sounds, reported Australian Associated Press from the court.

Beaton told the court he resorted to master-servant treatment with his bulimic patient because other methods had failed. He said he thought forcing the woman to wear a dog collar and call him master would build a more trusting relationship.

He said such treatment was allowed by the Australian Psychological Society. "It is right within the ethical guidelines," Beaton told the court.

"I am not saying it would be all right if I hit her. I did not hit her," he said. The trial continues.



I mean, what can you say? This story is just overflowing with wrong.

I wonder why the police were secretly videotaping the sessions. did this guy have a history of prescribing dog collars off-label? Had the woman tipped off the cops that he was abusive prior to this?

is the treatment for bulimia that new and unregulated that such dangerous "therapies" are tried frequently? is there any sort of treatment protocol, or oversight, or are all therapists and their clients still feeling their way around?

I mean, I'm neither bulimic nor a therapist. So I'm not sure what could have taken place in therapy to lead the doc into saying "That's it! I've got it! Of course! Here's what we'll do..."

any time I hear about doctors forcing I get a little concerned. Maybe that's the core of the matter.

comments?

Comments:
yep, thats fucked up, but I hate shrinks to start with...

wv, no shit : psyfow
 
I'm just bewildered. since when is that a viable treatment plan? what page of the DSM IV is that even on?

I mean, I've participated in all manner of collar/leash activities (and didn't die, and thought it was fun), but never in a "therapeutic" capacity. but I was never forced, and it was never treated as "here, this'll cure what ails ya, missy!"

and why were the police involved anyway?
 
besides being an unethical perv, he confuses me. are we sure they werent having a fling? cause, yeah, that goes against like, the first and most important rule of psychiatry but lets be honest here...dog collars, humiliation and whips arent the best way to establish trust if that aint your kink (worst excuse EVER), and she certainly should have known better than to keep going with him. Interesting....if she didnt trust him enough, you'd think she wouldnt have kept coming back. And the whole police thing reminds me of the time i got picked up for shoplifting because i was wearing pants under my skirt (im not very fashionable) and the store people looked under the dressing room door and assumed i stole them. They must have been there at the consent or request of one of his patients, but doesnt that violate doctor-patient privilege if it wasn't her?
 
Sounds like he was enjoying a bit of master-slave privilege, not just the collar thing, but being in a position of authority (40 yrs older than her)on several levels. Unethical as all get out. The trust between a therapist and client is like a parent-child thing, and should never cross a sexual boundary.
And as a cure for bulemia? please.
 
The trust between a therapist and client is like a parent-child thing, and should never cross a sexual boundary.

is it possible (?) that the doc wasn't keyed into the sexual aspect of it?

I mean, if he had been practicing psychotherapy on the Island of Atlantis for several years, and maybe missed the whole BDSM "boom"?
 
is it possible (?) that the doc wasn't keyed into the sexual aspect of it?

I mean, if he had been practicing psychotherapy on the Island of Atlantis for several years, and maybe missed the whole BDSM "boom"?



in a word: no.

and even if there were some way to argue that this -wasn't- sexual, there is no way in hell this is ethical by anyone's standards. nope. uh uh. sorry.
 
Antiprincess, you are by far the most...willing to give someone the benefit of the doubt (that's it. I had to think a minute)...person I have come across in a long time. It's rare that one comes across an individual who rolls an issue around the way you do- looking at it from all angles and possibilities. It's a good thing, don't lose it.
 
Antiprincess, you are by far the most...willing to give someone the benefit of the doubt (that's it. I had to think a minute)...person I have come across in a long time. It's rare that one comes across an individual who rolls an issue around the way you do- looking at it from all angles and possibilities. It's a good thing, don't lose it.
 
Antiprincess, you are by far the most...willing to give someone the benefit of the doubt (that's it. I had to think a minute)...person I have come across in a long time. It's rare that one comes across an individual who rolls an issue around the way you do- looking at it from all angles and possibilities. It's a good thing, don't lose it.
 
Fucked up, yes. But realise that these psychologists and shrinks have to somehow fill the enormous gap between what the powers that be in conventional society consider to be reality and what actually is reality. This must stress them out, too.
 
that had not occured to me, Unsane.

I hate to look like an apologist for perverts, but for me it's not always enough to say "Shock! Horror! Deplore!" though the behavior under discussion may well be nothing but shocking, horrifying and deplorable.

if it's possible to figure out the spot where the disconnect from reality takes place, maybe it's possible to resolve it so that going forward it will be easier to correct.

and the way to do that, in my opinion, is to look at it from all angles, even if some of those angles are improbable, disturbing or just icky.
 
okay, speaking as a psychologist/shrink in training (at least if my application gets accepted), i really gotta say something here. No, that is not part of the System any more than any other broad position of authority is. Just...no.
 
I still can't figure out what the cameras were doing there.
 
"and the way to do that, in my opinion, is to look at it from all angles, even if some of those angles are improbable, disturbing or just icky. "

Sure, that has to be done in order to learn from the event, but it is also possible(and occasionally necessary) to say "WRONG" in order to stop the behavior before it goes further, and then examine it. I do that with my kids all the time. Somtimes, judgements must be made. And sometimes. things really are *wrong*, and we know it immediately.
 
and not because it's "perverted;" look at it this way, okay: what would you think of a teacher doing this? Or a social worker? Or a doctor? Or a director? (of something like an Ibsen play, I mean; and y'know even if it is -that- sort of play/film, there are boundary issues wrt what the director can do to the actor -directly-).
 
I do that with my kids all the time. Somtimes, judgements must be made. And sometimes. things really are *wrong*, and we know it immediately.

oh, I get the "wrong" part.

but people don't set out, generally speaking, to commit acts of "wrong". I don't get the sense that Dr. Insufferable-Jerk woke up one morning and said "I think I'll mess with my patient's head today because I feel like being evil and damaging my patient."

at some point along the process of deciding what the right thing to do for his patient was, it occurred to him that collaring her was not only an option, but the best option.

something so obviously and absurdly wrong to us had to seem logical and ethical and correct to him.

that's what I'm stuck on.
 
i think, you know, there are answers to that sort of question; it's just you won't find them through the rational sorts of ways one normally thinks of when asking/answering such questions.

since we're talking shrinkage anyway, some reading recommendations:

this article

from this website, which has many articles i've found valuable.

Voicelessness and Emotional Survival

but more to the point, perhaps:

Narcissists use everyone around them to keep themselves inflated. Often they find flaws in others and criticize them fiercely, for this further distinguishes them from those who are defective. Children are ready targets: narcissists consider children flawed and lacking, and therefore most in need of severe "teaching" and correction. This negative picture of children is a sad projection of how the narcissist truly feels about his or her inner self before the self-inflation began. But the narcissist never recognizes this: they consider their harsh, controlling parenting magnanimous and in the child's best interest. Spouses receive similar treatment--they exist to admire the narcissist and to remain in the background as an adornment. Frequently, spouses are subject to the same barrage of criticism. This can never be effectively countered, because any assertive defense is a threat to the narcissist's wounded "self." Not surprisingly, narcissists cannot hear others: spouse, lover, or friends, and especially not children. They are interested in listening only to the extent that it allows them the opportunity to give advice or share a similar incident (either better or worse, depending upon which has more impact). Many engage in "sham" listening, appearing to be very attentive because they want to look good. Usually they are unaware of their deafness--in fact they believe they hear better than anyone else (this belief, of course, is another attempt at self-inflation). Because of their underlying need for voice and the resultant bluster, narcissists often work their way to the center of their "circle," or the top of their organization. Indeed, they may be the mentor or guru for others. The second they are snubbed, however, they rage at their "enemy".

Now just substitute therapist for "guru." (priest, teacher...what you will).

after all, what better place for hiding in plain sight? for "I'm only trying to help you, dear."

and it's this sort of bullshit that makes everyone -else's- job so much more damn difficult.

and yah, there are institutional factors as well that buttress such personalities/abuses to varying degrees, and it is true that traditional individual-oriented psych doesn't always deal with that so well; still, it is possible to talk about organizational pathology as well as problems with the individual behavior, or indeed in conjunction.
 
there is also this, from this website

High functioning are the ones who "fool everyone" into thinking that they are ’Mr. or Ms. Wonderful’, and reserve the extreme BPD behaviors for their partners or children. On the surface they appear to function well in the majority of areas their lives. They are frequently psychiatrists, social workers, clinical therapists, or otherwise involved in the caring industry. A second sub-set do very well in the military/prison system or customs where they are in control of those around them, in positions like: military officers, police officers, prison guards or customs officers.

These careers can and often do offer lots of rewards and reinforcement for black and white thinking, splitting, and an excessive need for power and control over others. The criminal or the speeder is the ’bad guy’ and they (BPD) are therefore ’the good guy’. What they do is ’right’, therefore they are ’good people’. These professions offer lots of positive reinforcement for BPD behaviors and patterns as well as places for excessive control over others to be tacitly or actively rewarded.


anyway, the thing about extending empathy to a guy like this--trying to put oneself in his shoes--is that, clearly and grossly, he is doing no such thing himself. He thought what he did was the right thing to do; ergo, it was. Full stop. There is a disconnect, there.

i don't know how or why the police were involved; that is a whole 'nother level of fucked up.

unless the woman brought them in; but, hoooo boy, i dunno, plot thickens.
 
involved -videotaping,- that is.
 
Eating disorder treatment is counseling--it's about learning not to (a) hurt yourself and (b) hate yourself. At the crisis level, it works just like rehab programs for substance abuse. It's not a cakewalk, any more than recovering from any other self-destructive regime, butit's pretty straightforward. I've heard of ED therapy incorporated into different counseling techniques, but it's not experimental. It is standardized. This is on par with treating alcoholism via exorcism. And just in general, it's _not okay_ for a mental-health professional to play any sort of sexualized game with his or her patients or invade their personal space, full stop forever.

I don't think it was a treatment thing for him at all--that is, that he was thinking of it as a way to treat a patient with an eating disorder. I think he just used this as an opportunity to sexually assault her. He might have justified it to himself in any number of ways, but there are countless customary rationales that don't even need to bother with the patient/physician relationship or the therapeutic setting.

In conclusion, God, what an reprehensible fuck. What kind of sick asshole gives someone post-traumatic issues around seeking psychiatric help? It's like a rape-crisis counselor getting caught stalking clients. I hope she gets the assistance she needs, both for this and for her original problem. This is probably going to swing it into overdrive.
 
don't think it was a treatment thing for him at all--that is, that he was thinking of it as a way to treat a patient with an eating disorder. I think he just used this as an opportunity to sexually assault her. He might have justified it to himself in any number of ways, but there are countless customary rationales that don't even need to bother with the patient/physician relationship or the therapeutic setting.

In conclusion, God, what an reprehensible fuck. What kind of sick asshole gives someone post-traumatic issues around seeking psychiatric help? It's like a rape-crisis counselor getting caught stalking clients. I hope she gets the assistance she needs, both for this and for her original problem. This is probably going to swing it into overdrive.


yup.

"sanctuary trauma," abuse in the very place you're supposed to feel safe, by the people who're supposed to be helping you: there is or ought to be a special name for that sort of abuse. ("spiritual abuse," perhaps?) and, there is certainly a special place in hell.
 
I've heard of ED therapy incorporated into different counseling techniques, but it's not experimental. It is standardized.

how is it treated?
 
Well, like I said, at the severe level the treatment is like rehab: you're supervised because you can't control your disordered behavior well enough to ensure saffety.

But at the more normal level...just like everything else. You and your therapist sit down long-term and talk about what you're doing, why you need to do this, and what you can do to curtail the behaviors and the mindset behind them. The sessions I've had sound like, So, what happened today? Okay, so do you think that was a good idea? Did that work well for you? How did it make you feel? Why do you think it made you feel that way? Is it an improvement on what you did yesterday/last week/last month? What do you think you could have done that might have been better for you or made you feel better? It's about identifying bad patterns--e.g. feelings of self-hatred after skipping a workout, the need to vomit after a meal--and getting the patient to look critically at them.
 
seems like the treatment plan is pretty straightforward.

How on earth did he think he'd get away with it?
 
And some of the self-check examples are things like, Do I want to work out because it'll feel good or because I worry about getting fat and gross if I don't? When was the last time I ate something? Am I thinking about food/weight/my body because I'm stressed out about something else? Why do I feel like relapsing right this second--what's going on with me right now?

The problems IME were:

1) Incredibly self-destructive series of habits.

2) Stress from the aforementioned, which are not merely dangerous but incredibly painful and exhausting.

3) Great big fat holes in one's life that the self-destructive habits used to fill up quite nicely--nothing like an obsession to take up your time.

3) Lack of normal coping mechanisms for stress--including, perhaps most importantly, real friendships and community.

4) Lack of self-awareness around stress (and any number of other things).

5) Unrealistic, perfectionist expectations about everything, including recovery.

6) Tendency towards self-hatred for any reason, including vulnerability.

7) Weight gain from your exhausted, defensive, famine-set body.
 
He probably thought--and I suspect he was right about her and probably other patients, at least for a little while--that she'd yield to what she perceived as authority. First of all, people trust professionals. Second, she might not have been as critical as she needed to be (which just to be clear is not excusing the fuckwad one iota), either because people aren't or because ED sufferers very frequently aren't. She might not have been very good at second-guessing offered solutions; she might have been eager to do something right now; she might have not been very good at entertaining doubt once she'd committed to a plan. Third, he was probably skilled enough to exploit her particular problems--to make her feel as though any bad feelings on her part were weakness, were hindrance, were failure. I'm a layperson talking on a random blog from thousands of miles away, and so this is all extremely idle speculation, but that's what I suspect.
 
yup.
 
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