Corruption Among the Flock

- submitted by a reader who took what they called a “snapshot” of the postings before they were taken down. It displays the lengths Hansard’s supporters are willing to go to defame his victims, enable his actions and illness and to carry on abusing others.

Reply posted on website in response to last posting by a Hansard supporter stating that Hansard's victims had "lost" their battle and he had therefore "won".

In this posting the poster is pleading with the owner of the site not to present a bias as their postings have been censored previously. No such luck however, as the last poster who appears to be taunting the victims is granted the last word by the so called "moderator" of the site.

It would appear the posting remained for less than a day, as the poster submitted their comments on Monday June 22nd, and the snapshot was taken on the same day, though the poster and the reader may in all likelihood be in different countries entirely. Let there be no doubt that Christopher Hansard’s arm of abuse reached across oceans.

In Summary…

“Thank you for your contribution Mr. Livingstone.
This is indeed the Christopher Hansard you speak of. He has now been published by Hodder & Stoughton Publishers in the UK and America and continues to be promoted by his book agent Kay McCauley. Despite repeated attempts to contact those closest to him either in personal or professional capacities, urging them to get him some much overdue and needed ‘help’ or at the very least away from the public he has manipulated and abused over the span of his career, his former psychotherapists are now encouraging him to seek further “education” through various psychotherapy courses, (the latest being with Henry Whitfield in London which is being endorsed by B.A.A.M.), thereby equipping him with the tools needed to further manipulate and coerce those in his care into submitting themselves sexually to him in his ‘treatment’ rooms under the guise of ‘healing’, and into believing that he has acquired the previous education and tutelage of a Tibetan man he called Urygen Nam Chuk in his 3 publications. Mr. Hansard has become a fraud, and a sexual predator, and most unfortunate is the fact that some otherwise respectable upstanding citizens continue to endorse him, adding to his credibility and drawing future victims to him.”

Latest Defense by client Mr. F. Roussel

“Support/ Enable Christopher Hansard”

http://supportchristopherhansard.blogspot.com/search?updated-min=2009-01-01T00%3A00%3A00-08%3A00&updated-max=2010-01-01T00%3A00%3A00-08%3A00&max-results=2

What Mr. Roussel is unaware of is that the many allegations are indeed true. Victims had and continue to approach the police both in the UK and Canada. Coercion is however a difficult matter.

What Mr. Roussel is perhaps also unaware of is the law. If Christopher Hansard does decide to “defend” himself by going after those making online allegations, he knows well as the above poster also states, that it will unify his victims en masse. It is perhaps something they wait for, some more eagerly than others, as for now many who were conned still live in shame. Some were conned financially, others sexually under the guise of investment, spirituality and “love”.  Both forms abuse hit right to the core and shattered their very being.

‘We’ the victims offer you our sincere sympathies Mr. Roussel, as we all found ourselves defending Christopher Hansard at one time as well… It was our defense and denial that allowed him to go on to abuse others…

Christopher Hansard’s story of his training is untrue. It is a falsehood, a fallacy and he is fraud. It is not only because he cannot and will not ever be able to “prove” the story of his teachings, his teacher, nor his teacher’s family that supposedly existed alongside him as well, it is because it was reported that he told not just one but three people the ‘truth’, one being his own psychotherapist in London.

In short, the truth is out there…

LOUGHTON: Arts therapist struck off

11:15am Tuesday 2nd June 2009

Comments (11) Have your say »

AN arts therapist who fell asleep during sessions with patients, swore at them and suggested one take advantage of “unlimited sex” has been struck off.

Derek Gale, who practiced at the Gale Centre, in Whitakers Way, Loughton, also smoked cannabis in front of patients, made a number of them help rebuild his practice, and wrote to one signing himself “daddy”.

The Health Professions Council’s Conduct and Competence Committee has been hearing evidence against Mr Gale since March with four former patients making allegations against him.

Among allegations upheld by the HPC are that he read one patient, JB, a bedtime story while playing with her hair and pinging her bra strap.

During a one-to-one therapy sessions with the same client he told her he was writing a novel in which the main character was a therapist who “Gets f***** in every way” and “gets f***** by the client.”

Mr Gale also admitted he told the patient a fantasy he had of dropping his trousers in front of his ex-wife.

He asked another client, GD, to cut his hair for free, and told other members to help him re-build the Gale Centre.

During the hearing Mr Gale described himself as “A ‘non-mainstream’ practitioner who adopts a confrontational and provocative position in relation to his clients in both individual and group settings”.

The committee heard that Mr Gale often went on holiday with another client, broke another patient’s confidentiality by telling his group she was self-harming, and failed to keep full notes.

Its report summary states: “The Panel has come to the firm view that he has a cavalier attitude towards the needs of clients and the requirement to follow guidelines.

“Mr Gale’s current fitness to practise is impaired because a person who is capable of adopting this attitude represents a significant risk to clients who may come his way, and that there is this risk with some potential clients is not negated by the acknowledged fact that he has helped people.”

Mr Gale has been struck off the HPC’s register.

Speaking to The Guardian after the hearing, one former client, who asked not to be named, said: “It was what we were hoping for. It was a long and difficult case and they did their job admirably.

“I don’t think he’s fully aware of the damage that he does, and it’s a concern. I think we all survive these things but it’s taken a long time to come to terms with the fact and impact it’s had on my life. The HPC verdict has offered a certain amount of closure but it’s a concern that he continues to practice.”

____________________________________________________

Below are some comments that are sadly not unlike those discussions we have all witnessed taking place on the blogs, online forums, and websites surrounding Christopher Hansard. For those who were not victims themselves who maintain friendships it is hard to believe that their “friend” can be equally manipulative and predatory as he can be “kind” and seemingly “generous”.

However the reality remains. A reality severely and possibly irreparably distorted for those lost in Hansard’s world of “Spirituality, Self-help, and Self Knowledge”

LOUGHTON: Arts therapist struck off

11:15am Tuesday 2nd June 2009

Comments (11) Have your say »

AN arts therapist who fell asleep during sessions with patients, swore at them and suggested one take advantage of “unlimited sex” has been struck off.

Derek Gale, who practiced at the Gale Centre, in Whitakers Way, Loughton, also smoked cannabis in front of patients, made a number of them help rebuild his practice, and wrote to one signing himself “daddy”.

The Health Professions Council’s Conduct and Competence Committee has been hearing evidence against Mr Gale since March with four former patients making allegations against him.

Among allegations upheld by the HPC are that he read one patient, JB, a bedtime story while playing with her hair and pinging her bra strap.

During a one-to-one therapy sessions with the same client he told her he was writing a novel in which the main character was a therapist who “Gets f***** in every way” and “gets f***** by the client.”

Mr Gale also admitted he told the patient a fantasy he had of dropping his trousers in front of his ex-wife.

He asked another client, GD, to cut his hair for free, and told other members to help him re-build the Gale Centre.

During the hearing Mr Gale described himself as “A ‘non-mainstream’ practitioner who adopts a confrontational and provocative position in relation to his clients in both individual and group settings”.

The committee heard that Mr Gale often went on holiday with another client, broke another patient’s confidentiality by telling his group she was self-harming, and failed to keep full notes.

Its report summary states: “The Panel has come to the firm view that he has a cavalier attitude towards the needs of clients and the requirement to follow guidelines.

“Mr Gale’s current fitness to practise is impaired because a person who is capable of adopting this attitude represents a significant risk to clients who may come his way, and that there is this risk with some potential clients is not negated by the acknowledged fact that he has helped people.”

Mr Gale has been struck off the HPC’s register.

Speaking to The Guardian after the hearing, one former client, who asked not to be named, said: “It was what we were hoping for. It was a long and difficult case and they did their job admirably.

“I don’t think he’s fully aware of the damage that he does, and it’s a concern. I think we all survive these things but it’s taken a long time to come to terms with the fact and impact it’s had on my life. The HPC verdict has offered a certain amount of closure but it’s a concern that he continues to practice.”

_______

galefriend, loughton says…
7:22pm Tue 2 Jun 09

Having read the news with great sadness regarding Mr Gale, I would like to respond on behalf of the hundreds of clients that he helped over the years that did not come out of the hate filled woodwork that plotted against him. I have known him for 35 years, our children grew up together and at no stage have I percieved any wrongdoing.Mr Gale was not perfect and was also a little unconventional but why keep returning for sessions, paying for them and then complaining about his approach and quite frankly some of the allegations were bizarre to say the least. At no stage of the reporting has there been a balanced view it was a witch-hunt by a group of people who should have gone for a more conventional route to deal with their therapy needs and perhaps accepted what was being said to them. I hope you are all happy with the result, I know a very kind, very loyal, very sympathetic man in Loughton who isnot this evening. Rock on HDG

_______

Galecult, Loughton says…
10:20pm Tue 2 Jun 09

Those who are defining themselves as friends of Gale should also note that the panel of the HPC also acknowledged that Mr Gale had helped people in the past but overwhelmingly accepted that his cavalier attitude to good practise is a risk to his clients – afterall how would you feel if you’re GP doctor told you that it would be good for you if you both got naked and went on holiday together? How would you feel if your GP made those type of suggestions to your wife or daughter and charges you large amounts of money for the privelege?

Preventing abuse in the complementary healthcare professions

This is just as likely to happen within the complementary healthcare field as within conventional healthcare settings, particularly as many complementary practitioners work with vulnerable people.

The Foundation is working with an organisation called WITNESS, a charity dedicated to helping people who have been abused by health and care workers.  Together we will increase awareness of the need for complementary practitioners to have clear and common professional boundaries.

Please support WITNESS

…meet the man behind the “healers” mask

Christopher Hansard’s story of his being trained by a Tibetan Master from the age of 4 are false. He has no such training or credentials, yet he has been allowed to publish 3 books advertising a skill set he clearly does not have.

The numerous advertisments and the media attention encouraged by an unsuspecting promotions and public relations company helped to maintain a somewhat steady stream of equally unsuspecting and more vulnerable clientele.

The Courant and others will continue to help the public make more informed, properly educated decisions before seeking a practitioner in what is meant to be a complementary, caring, field. There are indeed many professionals in the complementary and alternative health industry in the UK and we continue to encourage prospective clients to do careful research, and ask questions before submitting yourself to any form of ‘treatment’.

Your practitioner should in fact encourage such questions and should WANT you to be informed!

Do your own independent research, ask other practitioners, ask your doctor, ask your family and friends, and maintain contact and communication through out treatment with others. *You should not at any point be afraid, ashamed, or be told by your practitioner that your treatment is not to be discussed outside of the treatment room with others.

The below is from THE COMPLEMENTARY THERAPY ASSOCIATION

AN EXAMPLE OF THE MINIMUM CODE OF CONDUCT FOR AN AFFILIATED THERAPIST/PRACTITIONER.

The minimum standards set out in this Code of Conduct identify appropriate behaviour for Therapists/Practitioners and are intended to protect the public when they are given Complementary Therapies. All Therapists and Practitioners are expected to behave appropriately, take responsibility for their own actions and uphold public confidence in Complementary Therapies. An established set of procedures must be used whenever a complaint about a Therapist or Practitioner needs to be investigated, followed by the possibility of Disciplinary Action if the Code of Conduct has been breached. A Therapist or Practitioner who is the subject of a complaint must co-operate with the investigating body when called upon to do so, making a reasonable attempt to comply with the procedures and time-scales required.

All Therapists and Practitioners must always:-

Seek to improve their own knowledge and abilities.

Be respectful and courteous to others.

Remember that it is a legal requirement that children, up to the age of 16, must be accompanied by an adult.

Ensure that Professional conduct is exercised in all areas of interaction with a client.

Criticising and undermining professional colleagues is unacceptable and unprofessional.

Take responsibility for the relationship they have with their Clients and ensure that the trust placed in them is upheld.

Recognise their own limitations and seek help from those with greater skills and experience where required.

Maintain suitable working conditions where they give treatment and ensure where required, that they are safe and meet local authority regulations.

Have full insurance cover.

Be able to produce details of their professional identification, qualification and insurance when asked for by a client.

Whenever necessary, ascertain that their clients have sought medical advice and advising them where and when it is appropriate to do so.

Always be ready to co-operate with the Medical Profession.

Understand and act within the law as it relates to Specific Complementary Therapies e.g. Consent to Treatment, Child Protection, Sexually Transmitted Diseases, Infectious Diseases, Dentistry, Midwifery; The sale of Remedies, Herbs, Medicines, Supplements, Oils etc; and the Treatment of Animals. Also Confidentiality, Access to Clients records and the Data Protection Act.

In the event that a client needs go beyond the Therapists or Practitioners expertise, it is recommended practice to refer them to the relevant Medical or Complementary field.

All Therapists and Practitioners must Never:-

Consume alcohol while teaching, learning or practising a Complementary Therapy.

Use any titles or descriptions for themselves or their treatments that may mislead the public.

Give or offer any other form of treatment or therapy unless they are qualified and insured to do so without first making it clear to their Client and obtaining their clients specific consent.

Give any Complementary Therapy while medically or psychologically unfit to do so.

Give any Complementary Therapy as a Student or Probationer without being accompanied by a qualified Therapist or Practitioner unless they have been specifically authorised to do so and that the client agrees to receive treatment from a Student or Probationer under training.

Falsify documents or Clients notes.

*****Exploit or Abuse a Client sexually, emotionally or in any other way whatsoever.

Give Treatment when it is not safe or appropriate for the Client the Therapist or Practitioner.

Discriminate on the grounds of gender, race, religion, political persuasion, age or disability.

BEFORE GIVING TREATMENT, THERAPISTS OR PRACTITIONERS MUST ALWAYS:

Explain to a Client on a first visit how they give the treatment, how it is generally experienced and what the Client may expect with regard to consultations and fees.

Make it clear to a Client with which Complementary Therapy Organisation(s) they are registered with.

Ensure that the owner of an animal has given written confirmation that they have consulted a veterinary surgeon before giving healing to an animal and obtained their consent.
Never guarantee, promise, claim or imply a cure.

If practising Healing never charge a fee for Clients with venereal disease, as it is illegal to make a charge in these circumstances.

AFTER GIVING TREATMENT, THERAPISTS OR PRACTITIONERS MUST ALWAYS:

Keep clear concise notes of healing given to Clients.

Ensure that Client notes are kept in a safe locked place and retained for a minimum of seven years.

Keep confidential any information received from a Client unless it is required by law or is contrary to public interest (for example, there is a risk that Clients may cause harm to themselves, or to others, or have harm caused to them).

Hello,

I saw you have iSurvive listed as one of your resources and wanted to let you know a great way to support this tremendous non-profit organization. We are currently trying to involve bloggers to raise money, and it is as easy as making a post! I am a survivor and have found great support at iSurvive. I hope you will help the cause by “Blogging For A Cause”. Here is some more information, if you are interested: http://mymonsterhasaname.com/2009/05/isurvive-blogging-cause-part2/.

Thank you for being a part of the abuse survivor community!

My Monster

A bogus guru raped and sexually assaulted attractive women lured to his cult in a ten-year spree, a court heard

Michael Lyons, 51, styled himself as spiritualist Mohan Singh and victims were convinced he was linked to the Dalai Lama, it is alleged.

But in fact he is a ’sexual predator’ who raped and assaulted new or potentially new followers that he found attractive, a jury was told.

Prosecutor Philip Katz QC said: “We say the defendant, calling himself Mohan Singh, is a sexual predator masquerading as a Guru and healer.

“We say he has been systematically raping and sexually assaulting those new recruits into his group who he found attractive.”

Lyons is said to have attacked seven women from 1998 to 2008.

Wood Green Crown Court heard the victims would be brought to him after female devotees had praised him as being ‘enlightened’.

He would then criticise them and ask about whether they were sexually abused in the past, it was said. He would also convince them that he could help them, the court heard.

Bearded Lyons, who wore a purple robe in court, left one victim feeling drained and unable to move after performing a ‘violent’ neck twist on her and giving her acupuncture, the jury was told.

The court heard how Lyons was surrounded by a large group of young women who would follow his commands.

One victim, an American, said he raped her in July 1998, during a trip to London.

She said he had shown her a film which left her feeling ‘in a strange mental state’ before suddenly Lyons – who she knew as Mohan – was on top of her naked.

She told police: “I said something to the effect that I didn’t want to be doing this. He offered me more spiritual mumbo jumbo. He also said something along the lines that I was a tiger or a dragon.”

The woman, who cannot be named for legal reasons, said he had convinced her to stop taking medication.

She told the court: “I threw out my medication at some time during the time with Mohan because this person I believed to be affiliated with the Dalai Lama recommended it and I believed him to be trying to help me.”

Another alleged rape victim wept as she told the jury how she had been attacked at Lyons’ flat in north London in June 2002.

She said in a previous job in 1998 a female colleague called ‘Gina’ had tried to persuade her to meet Mohan. She said: “She told me he was an enlightened person. She presented him as a spiritual, maybe psychic person.”

Having declined those invitations, four years later Gina walked into a gym where the victim was now working and they agreed to meet up for a drink.

They met and Gina had brought along a large group of female friends, the court heard, before they eventually went back to a flat in Belsize Park where Lyons lived.

She told the court Lyons had criticised her for being Buddhist before emerging with a burning frying pan that smelt of herbs and wafted it around her mumbling incoherent words.

He then beckoned her to lie on a massage couch with the other women still around and Gina encouraging her, she said.

Once she was on the couch he twisted her neck suddenly, before remarking to the others: “Doesn’t she look better”. He then told her to walk around the circle of women who made comments about her, the victim said.

She said she began to feel ‘uncomfortable’ when she was singled out for special treatment like being given a blanket and particular drinks to sip from.

She told the court she “suddenly” came to her senses and wanted to leave but was told Mohan wanted to say goodbye and beckoned her to the massage couch again.

She said: “He manoeuvred my neck and it was so violent I thought he had broken my neck. I was completely stunned.

“Next I saw him putting acupuncture needles in me. He hadn’t asked me. I didn’t want him to put needles in me. I was just petrified.

“The girls said they were leaving and I said ‘not without me’ and Gina said ‘He needs to finish his treatment.”

After the acupuncture she collapsed and felt like she had ‘no strength’ before he ushered her into his bedroom and raped her despite her pleas for him to stop, the woman told the court.

Lyons, of Belsize Park, north London, denies five counts of rape and three counts of assault.

The trial continues.

Christopher Hansard is first and foremost an actor. A very very good one indeed…

Submitted on 2009/04/19 at 11:09pm

I knew a Christopher Hansard at Mt. Albert Grammar School, Auckland, New Zealand, form Upper Five, 1974…I wonder if this is the same guy ? I think he came from Auckland’s waterfront Orakei area, travelling out of the school zone.

His classmates included Graham Weavers, Chris Moonie, Mark Spencer, Nick de Witte, Burnett, Warwick, Gee,Pua, Laurenson, Larry Schwenke, Ta’afa Iusitini, Nadu Faimasasa, Taoa, Rando Pautu, Whooley, Mahoney, Kemp, myself,Rohan Addison,Kerry Thomas, Leslie, Dwyer,Colin McLaren and perhaps a few others who could be located.It was a tough class full of characters and ‘wild boys’.

He was nicknamed ‘Karate’ by most in the class because he adopted karate like poses when challenged or subjected to teenage banter. Hansard was at that stage repeating his 5th Form Year.He did not gel with a class load of strapping, sports mad Kiwi lads and took a lot of flak, possibly unfairly.He was a complex character even then, with a mop of curly dark hair and 5 o’clock shadow.

There were many incidents,I remember, which form an early picture.I do not remember Hansard being academic in Sciences or Arts to indicate a career in Medicine.

However, I do remember he wrote lots of worthy prose and meditative poetry, liking the Romantic poets like Byron. He was into literature and contributed to the school magazine, ‘The Albertian’.

On another occasion, I briefly worked in the design department of Auckland’s Museum of Transport and Technology around 1977, and Hansard was employed there.He took special interest in a thin, bohemian, arty girl called Lisa, I remember.

Later, probably 1980-81, he resurfaced as an actor/ theatre director in the Bohemian/ Gothic ‘Violent Theatre Company’ or similar name, based around Auckland University’s Maidment Theatre.

Over the years of travel and working all over, sometimes in demanding occupations, I never saw him again.Lo and behold, 30 years on, he resurfaces under a spotlight.

Is there a cure? Does someone just “change” one day after a lifetime of sexually abusing his patients and lying in 3 publications?

Adult pathological narcissism is no more “curable” than the entirety of one’s personality is disposable. The patient is a narcissist. Narcissism is more akin to the colour of one’s skin rather than to one’s choice of subjects at the university.

Moreover, the Narcissistic Personality Disorder (NPD) is frequently diagnosed with other, even more intractable personality disorders, mental illnesses, and substance abuse.

Adult narcissists can rarely be “cured”, though some scholars think otherwise. Still, the earlier the therapeutic intervention, the better the prognosis. A correct diagnosis and a proper mix of treatment modalities in early adolescence guarantees success without relapse in anywhere between one third and one half the cases. Additionally, ageing moderates or even vanquishes some antisocial behaviours.

Narcissistic Personality Disorder Treatment Modalities and Therapies

Frequently Asked Question # 77

Narcissism, Pathological Narcissism, The Narcissistic Personality Disorder (NPD), the Narcissist,

and Relationships with Abusive Narcissists and Psychopaths

By: Dr. Sam Vaknin

Malignant Self Love – Buy the Book – Click HERE!!!

Relationships with Abusive Narcissists – Buy the e-Books – Click HERE!!!

The WebSam Vaknin Sites

READ THIS: Scroll down to review a complete list of the articles – Click on the blue-coloured text!
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Is the Narcissistic Personality Disorder (NPD) more amenable to Cognitive-Behavioural therapies or to Psychodynamic/Psychoanalytic ones?

Answer:

Narcissism pervades the entire personality. It is all-pervasive. Being a narcissist is akin to being an alcoholic but much more so. Alcoholism is an impulsive behaviour. Narcissists exhibit dozens of similarly reckless behaviours, some of them uncontrollable (like their rage, the outcome of their wounded grandiosity). Narcissism is not a vocation. Narcissism resembles depression or other disorders and cannot be changed at will.

Adult pathological narcissism is no more “curable” than the entirety of one’s personality is disposable. The patient is a narcissist. Narcissism is more akin to the colour of one’s skin rather than to one’s choice of subjects at the university.

Moreover, the Narcissistic Personality Disorder (NPD) is frequently diagnosed with other, even more intractable personality disorders, mental illnesses, and substance abuse.

Cognitive-Behavioral Therapies (CBTs)

The CBTs postulate that insight – even if merely verbal and intellectual – is sufficient to induce an emotional outcome. Verbal cues, analyses of mantras we keep repeating (“I am ugly”, “I am afraid no one would like to be with me”), the itemizing of our inner dialogues and narratives and of our repeated behavioural patterns (learned behaviours) coupled with positive (and, rarely, negative) reinforcements – are used to induce a cumulative emotional effect tantamount to healing.

Psychodynamic theories reject the notion that cognition can influence emotion. Healing requires access to and the study of much deeper strata by both patient and therapist. The very exposure of these strata to the therapeutic is considered sufficient to induce a dynamic of healing.

The therapist’s role is either to interpret the material revealed to the patient (psychoanalysis) by allowing the patient to transfer past experience and superimpose it on the therapist – or to provide a safe emotional and holding environment conducive to changes in the patient.

The sad fact is that no known therapy is effective with narcissism itself, though a few therapies are reasonably successful as far as coping with some of its effects goes (behavioural modification).

Dynamic Psychotherapy
Or Psychodynamic Therapy, Psychoanalytic Psychotherapy

This is not psychoanalysis. It is an intensive psychotherapy based on psychoanalytic theory without the (very important) element of free association. This is not to say that free association is not used in these therapies – only that it is not a pillar of the technique. Dynamic therapies are usually applied to patients not considered “suitable” for psychoanalysis (such as those suffering from personality disorders, except the Avoidant PD).

Typically, different modes of interpretation are employed and other techniques borrowed from other treatments modalities. But the material interpreted is not necessarily the result of free association or dreams and the psychotherapist is a lot more active than the psychoanalyst.

Psychodynamic therapies are open-ended. At the commencement of the therapy, the therapist (analyst) makes an agreement (a “pact” or “alliance”) with the analysand (patient or client). The pact says that the patient undertakes to explore his problems for as long as may be needed. This is supposed to make the therapeutic environment much more relaxed because the patient knows that the analyst is at his/her disposal no matter how many meetings would be required in order to broach painful subject matter.

Sometimes, these therapies are divided to expressive versus supportive, but I regard this division as misleading.

Expressive means uncovering (making conscious) the patient’s conflicts and studying his or her defences and resistances. The analyst interprets the conflict in view of the new knowledge gained and guides the therapy towards a resolution of the conflict. The conflict, in other words, is “interpreted away” through insight and the change in the patient motivated by his/her insights.

The supportive therapies seek to strengthen the Ego. Their premise is that a strong Ego can cope better (and later on, alone) with external (situational) or internal (instinctual, related to drives) pressures. Supportive therapies seek to increase the patient’s ability to REPRESS conflicts (rather than bring them to the surface of consciousness).

When the patient’s painful conflicts are suppressed, the attendant dysphorias and symptoms vanish or are ameliorated. This is somewhat reminiscent of behaviourism (the main aim is to change behaviour and to relieve symptoms). It usually makes no use of insight or interpretation (though there are exceptions).

Group Therapies

Narcissists are notoriously unsuitable for collaborative efforts of any kind, let alone group therapy. They immediately size up others as potential Sources of Narcissistic Supply – or as potential competitors. They idealise the first (suppliers) and devalue the latter (competitors). This, obviously, is not very conducive to group therapy.

Moreover, the dynamic of the group is bound to reflect the interactions of its members. Narcissists are individualists. They regard coalitions with disdain and contempt. The need to resort to team work, to adhere to group rules, to succumb to a moderator, and to honour and respect the other members as equals is perceived by them to be humiliating and degrading (a contemptible weakness). Thus, a group containing one or more narcissists is likely to fluctuate between short-term, very small size, coalitions (based on “superiority” and contempt) and narcissistic outbreaks (acting outs) of rage and coercion.

Can Narcissism be Cured?

Adult narcissists can rarely be “cured”, though some scholars think otherwise. Still, the earlier the therapeutic intervention, the better the prognosis. A correct diagnosis and a proper mix of treatment modalities in early adolescence guarantees success without relapse in anywhere between one third and one half the cases. Additionally, ageing moderates or even vanquishes some antisocial behaviours.

“Most narcissists strongly resist psychotherapy. For those who choose to remain in therapy, there are several pitfalls that are difficult to avoid … Interpretation and even general assessment are often difficult to accomplish…”

The third edition of the “Oxford Textbook of Psychiatry” (Oxford, Oxford University Press, reprinted 2000), cautions (p. 128):

“… (P)eople cannot change their natures, but can only change their situations. There has been some progress in finding ways of effecting small changes in disorders of personality, but management still consists largely of helping the person to find a way of life that conflicts less with his character … Whatever treatment is used, aims should be modest and considerable time should be allowed to achieve them.”

The fourth edition of the authoritative “Review of General Psychiatry” (London, Prentice-Hall International, 1995), says (p. 309):

“(People with personality disorders) … cause resentment and possibly even alienation and burnout in the healthcare professionals who treat them … (p. 318) Long-term psychoanalytic psychotherapy and psychoanalysis have been attempted with (narcissists), although their use has been controversial.”

The reason narcissism is under-reported and healing over-stated is that therapists are being fooled by smart narcissists. Most narcissists are expert manipulators and consummate actors and they learn how to deceive their therapists.

Here are some hard facts:

• There are gradations and shades of narcissism. The differences between two narcissists can be great. The existence of grandiosity and empathy or lack thereof are not minor variations. They are serious predictors of future psychodynamics. The prognosis is much better if they do exist.

• There are cases of spontaneous healing, Acquired Situational Narcissism, and of “short-term NPD” [see Gunderson's and Ronningstam work, 1996].

• The prognosis for a classical narcissist (grandiosity, lack of empathy and all) is decidedly not good as far as long-term, lasting, and complete healing. Moreover, narcissists are intensely disliked by therapists.

BUT…

• Side effects, co-morbid disorders (such as Obsessive-Compulsive behaviors) and some aspects of NPD (the dysphorias, the persecutory delusions, the sense of entitlement, the pathological lying) can be modified (using talk therapy and, depending on the problem, medication). These are not long-term or complete solutions – but some of them do have long-term effects.

• The DSM is a billing and administration oriented diagnostic tool. It is intended to “tidy” up the psychiatrist’s desk. The Axis II Personality Disorders are ill demarcated. The differential diagnoses are vaguely defined. There are some cultural biases and judgements [see the diagnostic criteria of the Schizotypal and Antisocial PDs]. The result is sizeable confusion and multiple diagnoses (“co-morbidity”). NPD was introduced to the DSM in 1980 [DSM-III]. There isn’t enough research to substantiate any view or hypothesis about NPD. Future DSM editions may abolish it altogether within the framework of a cluster or a single “personality disorder” category. When we ask: “Can NPD be healed?” we need to realise that we don’t know for sure what is NPD and what constitutes long-term healing in the case of an NPD. There are those who seriously claim that NPD is a cultural disease (culture-bound) with a societal determinant.

Narcissists in Therapy

In therapy, the general idea is to create the conditions for the True Self to resume its growth: safety, predictability, justice, love and acceptance – a mirroring, re-parenting, and holding environment. Therapy is supposed to provide these conditions of nurturance and guidance (through transference, cognitive re-labelling or other methods). The narcissist must learn that his past experiences are not laws of nature, that not all adults are abusive, that relationships can be nurturing and supportive.

Most therapists try to co-opt the narcissist’s inflated ego (False Self) and defences. They compliment the narcissist, challenging him to prove his omnipotence by overcoming his disorder. They appeal to his quest for perfection, brilliance, and eternal love – and his paranoid tendencies – in an attempt to get rid of counterproductive, self-defeating, and dysfunctional behaviour patterns.

By stroking the narcissist’s grandiosity, they hope to modify or counter cognitive deficits, thinking errors, and the narcissist’s victim-stance. They contract with the narcissist to alter his conduct. Some even go to the extent of medicalizing the disorder, attributing it to a hereditary or biochemical origin and thus “absolving” the narcissist from his responsibility and freeing his mental resources to concentrate on the therapy.

(continued below)

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Confronting the narcissist head on and engaging in power politics (“I am cleverer”, “My will should prevail”, and so on) is decidedly unhelpful and could lead to rage attacks and a deepening of the narcissist’s persecutory delusions, bred by his humiliation in the therapeutic setting.

Successes have been reported by applying 12-step techniques (as modified for patients suffering from the Antisocial Personality Disorder), and with treatment modalities as diverse as NLP (Neurolinguistic Programming), Schema Therapy, and EMDR (Eye Movement Desensitization).

But, whatever the type of talk therapy, the narcissist devalues the therapist. His internal dialogue is: “I know best, I know it all, the therapist is less intelligent than I, I can’t afford the top level therapists who are the only ones qualified to treat me (as my equals, needless to say), I am actually a therapist myself…”

A litany of self-delusion and fantastic grandiosity (really, defences and resistances) ensues: “He (my therapist) should be my colleague, in certain respects it is he who should accept my professional authority, why won’t he be my friend, after all I can use the lingo (psycho-babble) even better than he does? It’s us (him and me) against a hostile and ignorant world (shared psychosis, folie a deux)…”

Then there is this internal dialog: “Just who does he think he is, asking me all these questions? What are his professional credentials? I am a success and he is a nobody therapist in a dingy office, he is trying to negate my uniqueness, he is an authority figure, I hate him, I will show him, I will humiliate him, prove him ignorant, have his licence revoked (transference). Actually, he is pitiable, a zero, a failure…”

And this is only in the first three sessions of the therapy. This abusive internal exchange becomes more vituperative and pejorative as therapy progresses.

Narcissists generally are averse to being medicated. Resorting to medicines is an implied admission that something is wrong. Narcissists are control freaks and hate to be “under the influence” of “mind altering” drugs prescribed to them by others.

Additionally, many of them believe that medication is the “great equaliser” – it will make them lose their uniqueness, superiority and so on. That is unless they can convincingly present the act of taking their medicines as “heroism”, a daring enterprise of self-exploration, part of a breakthrough clinical trial, and so on.

They often claim that the medicine affects them differently than it does other people, or that they have discovered a new, exciting way of using it, or that they are part of someone’s (usually themselves) learning curve (“part of a new approach to dosage”, “part of a new cocktail which holds great promise”). Narcissists must dramatise their lives to feel worthy and special. Aut nihil aut unique – either be special or don’t be at all. Narcissists are drama queens.

Very much like in the physical world, change is brought about only through incredible powers of torsion and breakage. Only when the narcissist’s elasticity gives way, only when he is wounded by his own intransigence – only then is there hope.

It takes nothing less than a real crisis. Ennui is not enough.

Also read

The Narcissist in Therapy

Getting Better

Testing the Abuser

Telling Them Apart

Facilitating Narcissism

Your Abuser in Therapy

Self Awareness and Healing

The Reconditioned Narcissist

Can the Narcissist Ever Get Better?

Narcissists and Biochemical Imbalances

Narcissists, Paranoiacs and Psychotherapists

Homosexual Narcissists

The Inverted Narcissist

The Myth of Mental Illness

Other Personality Disorders

Depression and the Narcissist

The Myth of Mental Illness

The Roots of Pedophilia

The Incest Taboo

In Defense of Psychoanalysis

Narcissism, Psychosis, and Delusions

Narcissistic Personality Disorder at a Glance

Eating Disorders and Personality Disorders

Use and abuse of Differential Diagnoses

Misdiagnosing Narcissism – The Bipolar I Disorder

Misdiagnosing Narcissism – Asperger’s Disorder

Misdiagnosing Narcissism – Generalized Anxiety Disorder

Narcissists, Inverted Narcissists and Schizoids

Narcissism, Substance Abuse, and Reckless Behaviours

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This article appears in my book, “Malignant Self Love – Narcissism Revisited”

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In Christopher Hansard’s case, there is none. He has no credentials, and no professional designations despite presenting himself as a Doctor and Physician. Christopher Hansard has no accountability as a complementary practitioner or Spiritual Shaman. Nor does he have remorse for the alleged abuses of his patients and students who were predominantly female, as he continues to carry on such abuses under the guise of teachings and healing.

Professional Accountability

Having acknowledged that some therapists have been engaging in sexual intimacies with people who have come to them for help, we must determine the degree to which we are willing to affirm and support actively and effectively the long-standing prohibition against the practice and to hold ourselves genuinely accountable for violating the prohibition. It has been suggested that one of the primary reasons that health care professions have experienced such difficulty responding realistically and effectively to rape and incest is that the populations both of perpetrators and of health care professionals have historically been predominantly male (e.g., Masson, 1986). The male professional’s sense of identification with the male perpetrator (intensified because both roles-health care professional and sex abuse perpetrator-involve being the more powerful member of a private dyad) may, according to this view, elicit the professional’s collusion in exonerating the perpetrator’s accountability for his acts and/or enabling the perpetrator to continue the abuse (e.g,, through unsubstantiated claims of “rehabilitation”). Thus the professional is placing an aspect of (perceived) self-interest (based on identification with the perpetrator) above the interests or needs of the victim.

Health care professions, like any professions, struggle constantly with the conflict between “self-interests” (often termed “guild interests”) and the ethic that professionals will scrupulously act in ways that safeguard the safety of patients. In an analysis of issues related to the withholding of care from people suffering from AIDS, Pellegrino (1987), of the Kennedy Institute of Ethics, wrote

Nothing more exposes a physician’s true ethics than the way he or she balances his or her own interests against those of the patient. Whether the physician is refusing care for patients with the acquired immunodeficiency syndrome (AIDS) for fear of contagion … or withdrawing from emergency department service for fear of malpractice suits, striking for better pay or fees, or earning a gatekeeper’s bonus by blocking access to medical care, the question raised is the same. (p. 1939)

Pellegrino argued that it is various aspects of a commitment to forgo certain self-interests in order to protect or serve the welfare of patients “that distinguish medicine from business and most other careers or forms of livelihood” (p. 1939). Medicine’s commitment to such a professional ethic may be in the process of erosion. The president of the Association of American Medical Colleges, for example, noted that “studies show that medical students are lenient towards dishonesty in education and practice” (Petersdorf, 1989, p. 119). Students’ lenient attitudes toward fraudulent practices that benefit the professional at the expense of the patient may be influenced by the less-than-vigorous systems of discipline and accountability in which physicians play an active role. An extensive study, for example, concluded, “Physician discipline in California is a code blue emergency. The system cannot and does not protect Californians from incompetent medical practice” (Center for Public Interest Law, 1989, p. 1). For further examples and discussion of professional review boards, see Sonne and Pope (in press) .

The resistance to accountability and resultant erosion of effective monitoring of compliance with professional standards may be operative in the area of therapist-patient sexual intimacies. The American Psychiatric Association, for example, has been criticized by some members for its failure to address this issue in good faith. Gartrell, a former professor at Harvard who was principal investigator in the first national study of sexual intimacies between psychiatrists and their patients (Gartrell, Herman, Olarte, Feldstein, & Localio, 1986, 1987 , 1989), resigned her membership in the American Psychiatric Association in protest of what she considered their failure to act effectively to maintain the prohibition, to protect patients, and to hold perpetrators accountable (personal communication, November 14, 1989). Similarly, Gay, a member of the American Psychiatric Association who has been deeply involved in efforts to hold therapists accountable for sexual abuse of their patients concluded, “I used to believe the [American Psychiatric Association]… . But they want to have one image publicly, then the way they act supports a completely different conclusion. I think the [American Psychiatric Association] is not part of the solution; I think the [American Psychiatric Association] is part of the problem” (Terwilliger, 1989c, p. F2). A former president of the American Psychiatric Association suggests that economic interests may heavily influence responses to accountability for victimization. Observing that liability insurance has traditionally served the dual purpose of protecting practitioners economically and compensating patients victimized by malpractice, A. A. Stone (1990) maintained that it is hard to justify the policy limits on payment to the (mostly female) victims of sexual exploitation by therapists. He noted that the economic selfinterest of these limits is “often presented with the windowdressing argument” (p. 25) that the perpetrators should not be protected. This conflict of interest, according to A. A. Stone, seems to lead to the placing of greater weight on economic self-interest (i.e., keeping malpractice premiums used to cover the costs of damages from becoming too expensive for therapists) than on the profession’s concern for victims. “The point is that the American Psychiatric Association will continue to have an economic interest in defending victimizing doctors who have committed the most egregious sexual exploitation if only to limit the amount of damages awarded” (p. 26). If psychologists are to create an effective method for eliminating the sexual abuse of patients, the possible tension between individual and collective self-interest and the safety of patients must be confronted forthrightly.

However, there is a second, related factor that may make it even more difficult to institute effective mechanisms of accountability. Many of us may be exceptionally wary of any efforts to monitor or regulate our actions, even (or especially) if such efforts are made by our own professional association. The history of the APA is interesting in this regard. The APA held its first meeting in 1892, ratified its constitution in 1894, and became incorporated in 1925. Yet it was not until the late 1930s that it was able to create an ethics committee in an attempt to ensure high standards among its membership. Prior attempts to regulate the practice of professional psychology included three separate efforts in the 1920s to establish a system of certifying psychologists performing clinical services (Fernberger, 1932). The third attempt ended when fewer than 30 psychologists could be persuaded to apply for certification-even when the application fee was drastically reduced from $35 to $5. The Committee on Certifications issued a report suggesting that by virtue of the scientific framework of the profession, psychologists, “while commonly energetic and at times heroic in the pursuit of personal aims and ideals, seldom exhibit the capacity for resolute common action which [would be necessary to maintain adequate standards despite] the energy and resources which would be mustered by [colleagues] charged with misconduct” (Fernberger, 1932, p. 50).

Accusations and Guilt; Denials and Innocence

A third pitfall can be anticipated from a study of responses to other forms of sex abuse: the danger of judging accusations or denials of therapist-patient sex to be always true or always false. Each accusation and denial must be painstakingly evaluated on an individual basis. This principle would seem so obviously self-evident as to be at best an innocuous truism. Yet the history of professional reactions to sexual abuse indicate how easily this principle is violated.

Perhaps influenced by Freud’s recantation of his seduction theory, many professionals and courts alike seemed to accept the premise that children’s allegations of incest or other forms of sexual abuse by adults were virtually always invalid (Masson, 1984; Miller, 1984 ; Rush, 1980). Other professionals, however, maintained that “young children never make up specific sexual stories or lie about who molested them” (Siegel, 1989, p. 29).

The phenomenon of sexual intimacies between therapists and patients may provoke similar tendencies to prejudge, especially in light of the issues involved and the tendency of sex abuse accusations to elicit intense emotional reactions. All of us must become aware of the ways in which our careful, unbiased evaluation of individual accusations and denials may be distorted by strong desires to protect innocent colleagues (and perhaps also those who engage in sexual abuse) from accusations, from involvement in formal hearings, and from sanctions, and to protect patients not only from victimization but also from revictimization that comes from having valid complaints discounted. Psychologists serving as expert witnesses in court settings or as members of ethics committees, licensing boards, hospital peer review committees, or other deliberative bodies have an especially significant responsibility to ensure that they render a thoroughly honest, truly professional judgment. Great harm is done to a practitioner innocent of any sexual involvement with a patient when a false accusation is, through carelessness, bias, or other factors, formally judged to be true. Great harm is done to both current and future victims of an actual perpetrator when a victim’s accusations are unfairly dismissed, discounted, or minimized. Psychologists must be particularly careful when using standardized tests to evaluate alleged perpetrators or alleged victims to ensure that the test has been adequately normed and validated for the relevant population and for the use to which it is being put, especially in light of evidence that failure to do so when using such tests as the Minnesota Multiphasic Personality Inventory (MMPI) can result in serious errors (Butcher & Pope, 1990; Pope & Bouhoutsos, 1986; Pope, Butcher, & Seelen, 2000).

The Nature of Information, Evidence, and Knowledge

A fourth challenge to psychology and allied health professions is in confronting the question, What forms of information or research evidence regarding sexual intimacies between therapists and patients will be considered persuasive (Pope, 1986)?

What we will accept as evidence regarding such intimacies depends in part on our epistemological assumptions. Numerous writers have explored the nature, validity, and implications of diverse scientific methods, with considerable attention to the social and behavioral sciences (e.g., Adair, 1973; Ash & Woodward, 1988; Bannister, 1987; Barber, 1976; Child, 1973; Cook & Campbell, 1979; Flanagan, 1988; Hilgard, 1987; Kuhn, 1962/1970, 1977; Manicas, 1987; Piaget, 1970/1977; Plutchik, 1968; Polanyi, 1958; Popper, 1935/1959; Rosaldo, 1989; Rosenthal & Rosnow, 1975; Rychlak, 1977; Sarason, 1988; Staats, 1981; Ziman, 1968). In his survey, Kimble (1984) found a diversity of views within the field of psychology. An extreme view holds that the only acceptable psychological method is that employed by a few (not all) of the natural sciences: Only when quantifiable variables can be isolated, randomly assigned, and manipulated in a controlled environment is the evidence acceptable. According to this view, paleontology, anthropology, ethology, and astronomy are not genuine sciences in that they rest primarily on careful and systematic observation of naturally occurring phenomena that do not permit substantial experimentation with completely isolated and randomly assigned variables in a controlled environment. This appears to be a minority view. M. Levine (1974) noted and endorsed the shift from the stance “that all problems are better handled with the logic of experimental design and statistical inference” to a general recognition that the real dilemma for psychology was to “distinguish between problems that can be studied by experimentation and those that cannot” (p. 664). A decade later, Wittig’s (1985) review of the field led her to conclude,

Most researchers in psychology recognize that exclusive reliance on the methods of the natural sciences does not provide a proper basis for psychology. The challenge is to gain consensus concerning the strength of the conclusion to be drawn, given the power of the techniques employed. (p. 805)

Whatever the customary epistemological stance may be, any association that finds itself accused of causing harm to the public (e.g., that members of mental health professions are sexually abusing their patients, are not acting vigorously and effectively to prevent this abuse, and are enabling perpetrators to resume practice with vulnerable patients on the basis of unvalidated claims of rehabilitation) may tend to defend itself by pointing out that any evidence of harm does not meet sufficiently rigorous scientific standards. The tobacco industry, for example, correctly points out that the evidence supporting the hypothesis that smoking harms or at least endangers humans does not meet certain scientific criteria (see, e.g., Patterson, 1987): (a) the animal studies-in which isolated variables are randomly assigned in a controlled environment (e.g., precise control of exactly how much smoke is inhaled over specified temporal intervals, of all facets of diet that might interact with smoking effects, of all environmental variables, of relevant genetic predispositions)-cannot be assumed to have direct implications for another species (i.e., humans), and (b) none of the human studies involve random assignment to smoking and nonsmoking groups or adequate isolation of variables; for example, all smokers are self-selected (thus introducing a bias of indeterminable magnitude), and those smokers who do volunteer for studies may differ in significant ways from those smokers who decline to participate.

Interestingly, when APA acquired Psychology Today, a venture hailed as “a far-sighted and sagacious move in the direction of social responsiveness [and] primary prevention” (Salameh, 1984, p. 4), it became the only health profession to generate considerable revenue by running advertisements that urged consumers to use tobacco products, although certain other types of advertisement were unacceptable. The APA Board of Directors unanimously agreed to issue a public policy statement in which the association did not characterize smoking as harmful (see, for example, the Surgeon General’s Warning on cigarette packets that “Smoking causes lung cancer, heart disease, emphysema, and may complicate pregnancy”) but rather adopted more scientifically conservative language, concordant with the tobacco industry’s position, to assert that cigarettes are one of a number of “products considered by some to be hazardous” (Advertising policy adopted for magazine, ” 1983, p. 2). It is crucial that we maintain an active awareness of the degree to which individual or collective defensiveness may be biasing our evaluations of whether certain actions actually cause harm.

The issue of what constitutes acceptable evidence is accentuated in the area of sexual abuse. As the professions began to overcome their resistance to acknowledging such phenomena, some professional authorities assumed that the activities labeled sexual abuse tended to be neither more nor less harmful than other forms of human sexual interactions. Kinsey, Pomeroy, Martin, and Gabbard (1953), for example, in their landmark text, Sexual Behavior in the Human Female, did not follow up on the fact that 80% of the girls who had engaged in sexual intimacies with adults reported that they were “emotionally upset and frightened.” The researchers viewed such relationships as essentially no different from those sexual relationships between adults in which one person has not assumed responsibilities relating to the welfare of the other, could not be considered to be more powerful than the other, and so forth. Any human sexual relationships, according to Kinsey and his colleagues, might produce a little upset; incest was not inherently different. Any general harm could be reasonably attributed only to outmoded cultural or professional biases against such relationships:

It is difficult to understand why a child, except for its cultural conditioning, should be disturbed at having its genitalia touched, or disturbed at seeing the genitalia of other persons, or disturbed at even more specific sex contacts…. Some of the more experienced students of juvenile problems have come to believe that the emotional reactions of parents, police officers, and other adults who discover that the child has had such a contact, may disturb the child more seriously than the sexual contacts themselves. (p. 121)

Those who assert that incest is no more generally harmful than sexual liaisons between adults in which one person has not assumed responsibilities relating to the welfare of the other, could not be considered to be in a more powerful position than the other, and so forth argue that fatally flawed research is being misinterpreted by people imbued with outmoded cultural prejudices. They compare incestuous activity to a private, self-initiated, and completely solitary sexual activity (which thus precludes consideration of issues of power or trust with a second party, fiduciary concerns, etc.). Herman (1981) noted the tendency of what she termed the “pro-incest school of thought” to use this comparison to masturbation. As Ramey (1979), a widely quoted sociologist, wrote, “We are roughly in the same position today regarding incest as we were a hundred years ago with respect to our fear of masturbation” (p. 1). Henderson (1983) likewise decried what he viewed as the unjustified prejudice against both masturbation and sexual intimacies between adults and children within a family, and quoted approvingly D. P. Orr’s dismissal of any evidence to date: “The studies used to support allegations that sexual abuse of children is damaging are biased and selected for children already identified as disturbed” (p. 38).

Some professionals, though rejecting any evidence of possible harm, may accept evidence of possible benefits. For example, in the chapter on “Incest” in the Comprehensive Textbook of Psychiatry, Henderson (1975) called attention to such methodological problems in the research as “unfortunate sampling procedures in the study designs” and, though unable to find adequate evidence of general harm, was able to conclude,

The father-daughter liaison satisfies instinctual drives in a setting where mutual alliance with an omnipotent adult condones the transgression. Moreover, the act offers an opportunity to test in reality an infantile fantasy whose consequences are found to be gratifying and pleasurable. It has even been suggested that the ego’s capacity for sublimation is favored by the pleasure afforded by incest and that such incestuous activity diminishes the subject’s chance of psychosis and allows a better adjustment to the external world. There is often found to be little deleterious influence on the subsequent personality of the incestuous daughter. One study found the vast majority to be none the worse for the experience…. (p. 1537)

Likewise, Karl Menninger, addressing the issue of sexual activity between children and adults, once noted that “when the experience actually stimulates the child erotically, it would appear … that it may favor rather than inhibit the development of social capabilities and mental health in the so-called victims” (cited by Dziech & Schudson, 1989, p. 8). Similarly, D. Thiessen’s paper, “Rape as a Reproductive Strategy, ” at the annual meeting of the APA in 1983, prompted consideration of whether rape might have certain benefits for women as a reproductive strategy. He asserted that “patterns of rape seem to follow normal correlates of consenting adults” and that such commonalities suggest that rape may possess “sexual and reproductive facets geared toward the reproductive facility of women” (quoted by Cunningham, 1983, p. 22).

In the area of sexual intimacies between therapists and persons with whom they have developed a professional, fiduciary relationship, it is crucial to confront realistically the nature of the research. For example, researchers have examined the effects of abuse on patients who did not return to a subsequent therapy as well as on those who did, have compared patients who were subjected to abuse by a prior therapist with matched groups of patients who were not victimized, and have explored the sequelae as evaluated variously by the patients themselves, by subsequent therapists, and by independent clinicians through methods including observation, clinical interviews, and standardized psychological testing (Belote, 1974; Bouhoutsos, Holroyd, Lerman, Forer, & Greenberg, 1983; Brown, 1988; Butler, 1975; Chesler, 1972; Durre, 1980; Feldman-Summers, 1989; Feldman-Summers & Jones, 1984; Sonne, 1989; Sonne, Meyer, Borys & Marshall, 1985; L. G. Stone, 1980; Vinson, 1984). Yet some might still argue that because it is impossible to assign subjects randomly, to isolate and control all variables, and so forth, researchers cannot determine whether therapist-patient sex, rape, incest, or other forms of abuse are generally harmful or are actually more likely to be enjoyable and beneficial to the (predominantly female) individuals who experience them and that attempts to answer such questions must rest solely on transient cultural prejudices rather than on acceptable scientific evidence. Riskin (1979) maintained that researchers will find out whether sexual intimacies with patients are generally harmful or beneficial only if they conduct experiments on patients in which therapist-patient sexual activity is the independent variable; he recommended that patients be randomly assigned to sexual and nonsexual treatment conditions.

If we do not reject all evidence concerning sexual abuse as failing to meet scientific criteria, we must take seriously the limitations and qualifications emphasized by reports of the research. For example, Holroyd and Brodsky (1977) stressed that it is “crucial to consider reliability issues” (p. 848); Bouhoutsos et al. (1983) emphasized that “the meaningfulness of these data … must be evaluated in the light of our sample characteristics… . We do not know the effects for patients who did not return to therapy” (p. 192); and Borys and Pope (1989) underscored six validity issues, one of which concerns a cluster of issues involved in their approach to data interpretation, including

problems in sample selection, the potential similarities and differences between responders and nonresponders in survey studies, issues in scaling and statistical analysis, [and] the qualified nature of inferences drawn from specific findings. (p. 289)

It is only when such qualifications regarding validity and reliability are carefully taken into account that what Wittig (1985) termed the “power of the techniques” can truly emerge and the difficult, often frustrating struggle to learn from diverse investigations–each adding a piece of the puzzle–can proceed.

The Nature of Perpetrators and the Questionable Nature and Efficacy of Rehabilitation

A prevalent societal and professional misconception about rapists and incest perpetrators has been (at least generally) laid to rest: that they are predominantly the least educated, least respected, most marginal members of the community (Barnard, Fuller, Robbins, & Shaw, 1989; Estrich, 1987). Lanyon (1986), for example, noted in his review of the literature that

Most prominent is the stereotype that child molesters are socially marginal persons or “dirty old men.” Indeed, the child molester is most commonly a respectable, otherwise law-abiding person, who may escape detection for exactly that reason. (p. 177)

Similarly, there emerged a stereotype (and, regrettably, it may have been cultivated by an embarrassed profession): that therapists who sexually abused patients were those marginal members of the profession who were most poorly trained. Such stereotypes served as the basis for numerous optimistic rehabilitation efforts that generally involved some combination of (a) education (e.g., an ethics tutorial, continuing case consultation or supervision, and individualized courses in issues such as countertransference, boundary management, and sexual material in psychotherapy), and (b) intensive, long-term psychotherapy lasting several years. Unfortunately, neither education nor psychotherapy has shown any evidence in published research studies of inhibiting sexual abuse of patients, and according to some studies, they actually appear to be positively associated with tendencies to abuse (Pope, 1990). For example, a national study of psychiatrists revealed that “offenders were more likely [than nonoffenders] … to have completed an accredited residency …, and to have undergone personal psychotherapy or psychoanalysis” (Gartrell et al., 1989, p. 7). Similarly, a national study of social workers revealed that personal therapy was not associated with lower rates of sexually abusing patients and that perpetrators were more likely than nonperpetrators to have fulfilled additional requirements for inclusion into the National Academy of Certified Social Workers (Gechtman, 1989). A study of knowledgeable, well-trained, and successful psychologists revealed a higher rate of sexual abuse of patients than that found in the more general surveys of psychologists (Pope & Bajt, 1988). It is worth considering whether high educational accomplishment and professional status may not only, in accordance with Lanyon’s (1986) speculation, help perpetrators to avoid detection but also contribute more generally to some psychologists’ sense that they and their colleagues are (or should be) above the law and beyond accountability to which other less entitled citizens are subject, that they are too elite and knowledgeable to be subject to such restraints, and that even to call their behavior formally into question is an affront and may be unethical. For example, in one study of exceptionally accomplished and respected senior psychologists (Pope & Bajt, 1988), 9% of those who reported intentionally breaking formal legal and ethical standards revealed that the standard they violated was the prohibition against sex with a patient and that this violation was an act of professional responsibility (i.e., that they engaged in sex with the client to promote “client welfare”). Another study of psychologists (Pope, Tabachnick, & Keith-Spiegel, 1987) revealed that 2.4% believed that to formally report a colleague’s harmful behavior under any circumstances was inherently unethical behavior on the part of the psychologist filing the complaint; an additional 12.8% believed that reporting such behavior was ethical only under rare circumstances.

Civil disobedience (a term coined by Thoreau, 1949/1960) was developed as a concept of ensuring accountability through voluntary acceptance of the penalties for breaking laws considered to be unjust and oppressive as a means of bringing about social change (Gandhi, 1948; King, 1986; Plato, 1956a, 1956b; Thoreau, 1849/1960; Tolstoi, 1894/1951). For psychologists to arrogate this term to avoid accountability for engaging in sexual abuse, keeping secret the sexual abuse of others, committing perjury, faking professional credentials and obtaining expensive gifts from clients seems, at best, misguided (see Pope & Bajt, 1988).

Sexually abusive psychotherapists cannot be dismissed as the most marginal members of the profession. They are well represented among the most prominent and respected mental health professionals. Cases involving therapists publicly reported to have engaged in sexual behaviors with their patients have included those who have served as faculty at the most prestigious universities (including those with APA-approved training programs), psychology licensing board chair, state psychological association ethics committee chair, psychoanalytic training institute director, state psychiatric association president, state association of marriage and family therapists president, prominent media psychologist, chief psychiatrist at a prominent psychiatric hospital, and chief psychiatrist at a state correctional facility (“APA’s Ethics Procedures Upheld,” 1985; Bass, 1989; Bloom, 1989; Colorado State Board of Examiners, 1988; Jalon, 1985; Matheson, 1984, 1985; Pugh, 1988; “The Resignation of ___ ___,” 1990; Smith, 1984). Bates and Brodsky (1989) described how one psychologist gained publicity by reporting a “nationwide survey” based on the conceptualization that sexually abusive therapists were in fact “impaired professionals”, the survey findings, which received newspaper coverage, supported efforts to “rehabilitate” these professionals. The psychologist also made a presentation on the subject of rehabilitating perpetrators at an annual meeting of the APA. The general public and the professional community, however, were probably not aware that this psychologist had been engaging in therapist-patient sexual intimacies and, several years after the APA presentation, pleaded guilty to a sex abuse charge (see Bates & Brodsky, 1989).

The ease of demonstrating the apparent successfulness of a rehabilitation program–even when the fundamental research requirement that data be collected and analyzed by independent, disinterested researchers (insofar as any efforts that we undertake to evaluate and publicize the appropriateness, successfulness, and downright brilliance of our own clinical work are rarely disinterested) is met–is due in part to the low base rate phenomenon. Cases of therapist-patient sex abuse have demonstrated that it is possible for perpetrators to engage in sex with their patients undetected (at least until one of the patients breaks the “secret” and files a complaint) while receiving close and direct case supervision, even when the supervision is conducted by an experienced and skilled psychologist under the mandate and auspices of a licensing board (in one instance reported by Bates & Brodsky, 1989, a malpractice suit was filed against both the perpetrator/therapist and the board-approved supervisor conducting the rehabilitation/monitoring), while working within a prestigious agency, and while maintaining a high public profile. Formal complaints from patients may be thus the only reliable way in which the failure of a rehabilitation effort can be discovered. Surveys of victims suggest that about 5% actually file formal complaints (e.g., Bouhoutsos, 1984; Pope & Bouhoutsos, 1986); the percentage seems to be significantly less than 5% when the number of cases estimated from anonymous surveys of therapists are compared with the number of complaints reported by regulatory agencies, ethics committees, and the civil courts.

What are the implications of these facts for rehabilitation? Assume that a hypothetical Sex Abuse Rehabilitation Institute will be created to work with 10 offenders referred by the state licensing board. After many years of intensive psychotherapy, education, and supervision–which, as noted earlier, have not shown evidence of effectiveness in preventing sexual abuse of patients–as well as careful use of other methods, the Institute honestly believes that these 10 psychologists have been fully rehabilitated and are ready to resume clinical practice, despite the relatively high tendency toward recidivism. [The APA Insurance Trust (1990) noted that "the recidivism rate for sexual misconduct is substantial (p. 3). The rate may be at least 80% (California Department of Consumer Affairs, 1990; Holroyd & Brodsky, 1977; Pope, 1989b; Sonne & Pope, in press).] Assume that the Institute’s interventions are completely ineffective and that every one of these 10 perpetrators will offend again (each with a new patient) once the licensing board allows each to resume practice. Even if the Institute and licensing board track the offenders for the next 20 years, what are the chances that they will discover that even one of the 10 therapists continued to abuse? According to the binomial probabilities, there is a 59.9% likelihood that none of the 10 subsequently abused patients will ever file a complaint. Thus the Institute and licensing board might in good faith publicize glowing findings that all 10 were rehabilitated and that patients and the public were adequately protected when in fact all 10 perpetrators continued to abuse.

At present, the diverse attempts to rehabilitate therapists who perpetrate sexual abuse have not demonstrated success in replicated research studies (even with the misleading “aid” of the low base rate phenomenon). Moreover, executive directors for the California licensing boards for psychologists, social workers, and marriage and family counselors have reviewed rehabilitation attempts. Having encountered more offenders than the licensing boards of other states, the California boards have had opportunity to test the widest variety of rehabilitation approaches. The executive directors concluded that in cases involving therapists who became sexually intimate with a patient, “prospects for rehabilitation are minimal and it is doubtful that they should be given the opportunity to ever practice psychotherapy again” (Callanan & O’Connor, 1988, p. 11).

The dilemma of rehabilitation is not limited to the highly questionable feasibility or demonstrated efficacy of rehabilitation. Among the other aspects of the dilemma are two major questions. First, what level of inviolable integrity and trust, if any, does the profession wish to affirm and sustain? A judge might take a bribe to decide a major case, lose the judgeship, subsequently pay the debt to society through a prison term, and undergo extensive rehabilitation; yet the judge would obviously not resume the bench. A teacher running a preschool might sexually abuse the children, subsequently undergo extensive treatment and rehabilitation and satisfy legal requirements (i.e., jail or probation), and seem to present no threat of further abuse; yet the teacher would not subsequently be granted a license to operate a preschool (unless, of course, the teacher was able to conceal this history of child molesting, perhaps by moving to another state and providing false answers during the application process). If people found to have used their positions of trust to accept bribes for rendering certain legal decisions or to victimize students were allowed to resume the positions of trust that they had betrayed, the nature of those positions-what they mean to the society and to those whose lives they influence-would be profoundly changed. Violation of a clearly understood prohibition against such a grave abuse of power and trust precludes further opportunity to hold these special positions in the legal or educational professions, although numerous other opportunities in law or education (e.g., research, writing, and consultation) remain available to the rehabilitated perpetrator.

Psychology must answer the question of whether psychotherapy involves, requires, and deserves the same level of inviolable trust (both from society and from those who are directly affected by the therapist) and integrity as judiciary and teaching roles within the legal and educational professions. The exceptional privacy and intensity of most psychotherapy relationships should not be overlooked when one confronts this question.

Second, to what degree does the profession affirm and ensure the rights to informed consent of patients directly affected by rehabilitation efforts? When new, not-yet-validated rehabilitation methods for perpetrators are being used on an experimental or trial basis by independent clinicians and professional boards, are the patients who are treated by the perpetrators during these initial investigative trials accorded full awareness and written informed consent to their participation, as the Ethical Principles in the Conduct of Research With Human Participants (APA, 1982) clearly seems to require? If the rehabilitation methods have already been independently validated, are the patients made aware of the nature of evidence supporting the validity of the approach and of any doubts, reservations, or qualifications regarding the safety and potential fallibility of the method? [Footnote1]

Our responsibility to scrutinize carefully the methods for ensuring informed consent used by clinicians, researchers, licensing boards, ethics committees, and others involved in rehabilitation efforts is vital: The patients placed at risk for serious harm are predominantly female, and informed consent procedures may be less adequate or completely nonexistent when risks for harm from experimental efforts fall mainly on women and minorities (Gallagher, 1990; R. J. Levine, 1988).

Psychologists must overcome professional resistance to the collection and public disclosure of such data (see the section on Acknowledging the Scope of the Phenomenon). It may also be worth considering whether any victim of rape, sexual abuse from a therapist or of incest who is considering seeking help from a therapist is genuinely aware that the therapist she or he selects may have sexually abused patients and has been returned to practice, after some sort of rehabilitation effort, by licensing boards.

A responsible professional stance is incompatible with neglect of these issues. All of us must maintain an active and knowledgeable awareness of such factors as (a) the consent forms and other components used by those (e.g., individual clinicians, professional licensing and ethics boards) who develop, study, publicize, and use rehabilitation attempts that have not yet been formally validated to ensure adequate informed consent by patients placed at risk by the perpetrators, and (b) the measures used to assess the reliability and validity of untested (i.e., having yet to show demonstrable effectiveness) approaches to rehabilitation, with special attention to how the psychometric properties of those measures and how the low base rate of discovery of abuse are taken into account.

more…

to be continued

Christopher Hansard – Once known as “Master Physician of Tibetan Dur Bon Medicine”, now in the process of gaining a certificate in counseling and Cognitive Behavioul Therapy has a long history of abusing those who turned to him for help. He delved for many years in sexual relations with his students and patients under the guise of “healing”. Though many of them went to him for treatment of diabetes, depression, or headaches, for Christopher Hansard, the answer to every problem was sex… with him.

But there is more than just one way to abuse your patient when you are in such a position of power, and there is an entire grooming process involved in preparing even your adult patients for sex in the treatment room…

There are many ways in which therapists and counsellors can abuse their clients. The list below, which does not claim to be exhaustive, is based on the experiences of some of those who have been abused in therapy. Categorising the suggestions has not always been easy: some behaviours fit into more than one category, and there is some overlap between the categories themselves. NB. The words “therapy” and “therapists” here should be taken to refer also to “counselling” and “counsellors” – or indeed to any kind of talking treatment and those who practise it.

“You Don’t Need To Know” – Withholding information

• Lying, withholding or distorting information
• Inflicting any kind of treatment modality on the client without discussing the treatment and particulars with client first and gaining their consent
• Not telling the client that the therapist is making some kind of assessment or diagnosis of them, and/or not informing the client of any diagnosis which has been made
• Not allowing client to critically question the therapy they are being subjected to, demanding unlimited compliance and agreement and “faith” in the therapeutic process
• Refusing to allow a client access to their client record
• Deliberately confusing a client in order to keep the client off-balance
• Refusal to explain terminology the therapist is using, such as any psychology or DSM terms
• Refusal to answer direct requests for clarification of the therapist’s words or non-verbal communications

“I’m in Charge” – Controlling, threatening and manipulative behaviour

• Shifting the balance of power further in favour of the therapist
• Refusal to address the issues which the client wishes to address in therapy
• Setting the client’s goals for them without reference to what the client sees as important, in relation to either therapy or life in general
• Making a client work on an issue on the therapist’s agenda or to his timing
• Threatening to have the client forcibly admitted to a mental hospital
• Guilt-tripping the client with phrases such as “You don’t want to get better”, “You have a problem with trust” etc.
• Using threats of termination to control a client’s actions, reactions, or behaviour
• Deliberately confusing a client so as to throw them off-balance
• Emotional blackmail and verbal assault
• Manipulation through the use of withdrawal and silence (e.g. encouraging client to overstate their distress so as to get a reaction)
• Unconditional positive regard (conveying the impression that the therapist cares and understands)
• Arbitrary, capricious or variable attitude to client (cf. “Good Cop, Bad Cop” routine)
• Making the client make “contracts” as a method of control (e.g. making a client be a “Pollyanna” by having a contract where the client must report “good things that have happened” regardless of the reality of the client’s life and recent happenings)
• Therapist passive-aggressively re-enacts a traumatic or abusive incident that client experienced, without client’s consent or knowledge of this “therapeutic technique”, just to see how client will respond

“I Know Best” – Misinterpretation of client’s symptoms/situation & imposing own beliefs/ preconceptions

• Not listening properly to clients – and only “hearing” what fits in with the therapist’s own preconceived ideas
• Defining clients in terms of the therapist’s own outlook, beliefs, ideals etc
• Using circular self-confirming hypotheses, i.e. basing assessments on the therapists’s conjecture rather than actual evidence, and then making further assumptions about the client based on those assessments
• Labelling understandable distress/anger etc at external events in terms of mental illness
• Insisting the client accepts the therapist’s interpretation of their distress and submits to a therapy protocol which is not designed for nor is effective for client’s specific problem (e.g. treating a depressed person for narcissistic or antisocial personality disorder)
• Developing endless attributions for client’s behaviour (e.g. depression/anxiety/OCD etc.) to justify solving it for a long time, and when behaviour is still present after therapy, develop a new attribution for the behaviour
• Making the client make “contracts” as a way to control the client or to minimise the client’s emotional situation, not as a useful therapy tool (e.g. where the client must report only “good things that have happened” regardless of the reality of the client’s life and recent happening)
• Using ANY type of spiritual/religious or otherwise-not-mainstream “therapy” without first explaining such and getting consent
• Insisting client adopt therapist’s belief system

“You Need Me” – Encouraging dependence & setting self up as only hope

• Persuading the client that the therapist is their only hope of happiness, and that they should accept and do everything the therapist says
• Encouraging an unhealthy dependence on therapy and/or the therapist
• Making extreme and seeming serious suggestions like cutting off contact with family members or verbally abusing family members, and justifying this behaviour by claiming it will “facilitate the therapeutic process”

Use of jargon, clichés, pretence and other inappropriate modes of address

• Using complex jargon to confuse and disadvantage the client
• Making jokes at the client’s expense
• Passing off abusive comments as “just a joke”
• Passing off superficial clichés as “insight” and “wisdom”
• Using manipulative phrases which contain a critical subtext, e.g.:
  • “This is life, you must learn to deal with it” (subtext: “You are deficient”)
  • “Choose to like where you are at, what you’ve got and to be with whoever you are with” (subtext: “Stop complaining”)
  • “I never promised you a rose garden” (subtext: “You are unreasonable” – when the only expectation may have been for decent and respectful behaviour!)
  • “Be grateful for what you have” (subtext: “You are ungrateful” )
  • “Do volunteer work” (subtext: “You are ungiving”)
  • “Now you’re sadder but wiser” (subtext: “Don’t be ungrateful – I’ve done something for you” – even though you sought help in dealing with the sadness)
  • “To have a friend you must be a friend” (subtext: “You are the problem – and if you say anything against other people, you’re paranoid”)
  • “There’s no such word as ‘can’t'” (subtext: “You are pathetic”, or “I don’t believe you”)
  • “Don’t you know that?” (subtext: “You ought to know that”)
  • “Don’t you want to get better?” (subtext: “You don’t want to get better”, or ” You will only get better if you do what I say”)
• Attempting to lead client to therapist’s predetermined conclusions by any of the following:
  • Lying, omitting or distorting information
  • Loaded questions
  • Feigning ignorance about a topic
  • Passing attributional suggestions off as compliments (e.g. “you are a tidy person”)
  • Making coercive/fear inducing statements (e.g. “that sounds pretty paranoid to me…”)
  • Feigning an anger response to client to regain control or compliance
  • Feigning identification with client’s feelings
  • Playing on client’s weaknesses/fears/needs/vulnerabilities
  • Setting client up by encouraging him/her to do something that will fail or appear silly
  • Playing games with client (e.g. therapist brings own problems into sessions and has an “iddn’t it terrible” competition – “you think you got problems, well, I’ll give you a reason to be depressed….”)

Causing disruption to client’s life, including breach of confidentiality

• Encouraging or causing disruption to client’s long term friendships and marital relationships
• Failing to respect client’s lifestyle choices as a “given”
• Discussing the client with others outside the therapy setting, unless the client has given explicit and informed consent to such discussions (which may include both giving and receiving information)
• Character assassination

Financial/material exploitation

• Using ANYTHING from a client for the therapist’s personal gain, without their knowledge (including the client’s story as an anecdotal case study for publication in a book)
• Keeping any item belonging to the client, even if the item was “created” during therapy or a session of therapy (poetry, artwork, journals etc), and refusing to return these items when asked to do so
• Using billing or financial arrangements to control or manipulate the client (e.g. requiring them to pay for a fixed number of sessions when client has decided to terminate early, or threatening to withdraw counselling which is being provided free or at reduced cost)

“It’s Your Fault” – Blaming the client & denial of any responsibility for distress in therapy

• “Pollyannaism” – emphasizing only good qualities, people are all nice, well-adjusted, polite, and kind, so if a problem occurs it’s the client’s fault, while ignoring/overlooking/minimizing bad things people do, or the possibility that people can deliberately do bad things to others; if client questions trustworthiness of others, he/she is labelled “paranoid”
• Demanding client “confess” to doing bad things as part of the therapeutic process and refusing to believe denials (e.g. using illegal narcotics, hurting other people, “being an asshole”, theft, lying)
• “Cure must fit the symptom” (i.e. if client has excessive guilt feelings, therapist insists client must have done something bad to make client feel guilty and must “come clean about what you did”)
• Treating the client as though he/she is malingering/feigning symptoms
• Saying a client is deliberately “dragging their feet” in getting well when the client is confused or does not understand what is going on in the therapy
• Labelling the client as manipulative or disturbed for questioning the therapist’s approach (e.g. diagnosing a personality disorder in order to discredit a client who makes a legitimate complaint)
• Labelling the client as resistant or in denial if they don’t accept the therapist’s understanding
• Refusing to accept that therapists ever make mistakes and blaming the client for any distress the therapist has caused them
• Character assassination
• Assuming all therapy “works”, even the latest fad, and if client doesn’t improve then they are “doing something wrong” (which entails many more hours of therapy) because the “theory” certainly cannot be at fault
• Playing the victim when the client makes a complaint

THE EFFECTS OF EMOTIONAL ABUSE FROM THERAPEUTIC SETTINGS

• Complete devastation and despair (feeling like Munch’s The Scream – see http://www.ivcc.edu/rambo/eng1001/munch.htm )
• Self blame and feelings of failure, guilt and confusion
• Loss of self-confidence and self-esteem, with excessive over-compensatory behaviour for new insecurities and fear about how others will respond to you
• Withdrawal and inability to talk about the abuse; and feeling also that no one understands
• Doubting your own perceptions and reality
• Post-traumatic stress, and ongoing high levels of stress
• Emotional detachment or “shutting down” (leading among other things to loss of empathy and lack of emotional response within oneself)
• Intrusive negative rumination/intrusive negative thoughts/flashbacks
• Extreme (but completely rational) fear of therapists and therapy
• Retraumatization in circumstances reminiscent of the abusive behaviour (this may lead to becoming unexpectedly or unduly upset with others, and even to adopting therapist’s abusive style in dealing with them)
• Breakdown of or disruption to client’s long-term friendships and marital relationships