The Christopher Hansard Courant

June 30, 2009

Therapist Struck Off

Guardian News

LOUGHTON: Arts therapist struck off

11:15am Tuesday 2nd June 2009

comment 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.”

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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

comment 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.”

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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

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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?

June 23, 2009

Before you buy the book…

…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).

June 1, 2009

Support and Healing

isurvive

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

April 7, 2009

Professional Accountability

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

April 6, 2009

How Therapist’s Abuse Their Clients

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…

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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

April 3, 2009

When “healers” do harm – Christopher Hansard

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“Sex on the couch: The therapists who abuse their clients’ trust”;

Sex on the couch: The therapists who abuse their clients’ trust

For a therapist, seducing a client is a wanton abuse of trust. Yet it’s far from rare.

By Julia Stuart

When Jo Adams was referred to the counsellor at her GP’s surgery, she expected to be given help for her severe depression. But that was not all she received. During the six sessions, her counsellor paid her a number of suggestive compliments. In her desperately ill state, they gave her a boost. “They put me on a false high, even though I’m happily married,” says the 35-year-old, who works in sales. “He made me laugh when I was suicidal. I felt I couldn’t do without him and if he went out of my life I would go back to the hell of depression I had known.”

When the sessions ended, she wrote to him to express her gratitude for helping her. For several months the pair exchanged letters. The counsellor, who was 20 years her senior, poured out his troubled personal life. One day he turned up at her doorstep and they embarked on a four-month relationship. As they kissed and cuddled, he would try to pressurise her into having sex, though she always refused. “It was all very manipulative,” she says. “He kept saying it was OK, but I knew it wasn’t. I felt powerless. I was very vulnerable. I was so ill, and saw this man as a way out of my depression. I thought I loved him.”

Ms Adams had a breakdown and told her husband. It was the first time in 20 years that she had seen him cry. She told the counsellor it had to stop, and a month later, following another mental collapse, she told a doctor at her surgery what had happened. “I was even more depressed than when I had gone to see [the counsellor],” says Ms Adams. “I was suicidal again and had to have someone with me for 24 hours a day for nine months. I blamed myself for a long time. I had a lot of self-hatred. It put my recovery back at least three years.” Two years later, she is still on medication.

The charity Witness, which supports people who have been abused by health and care workers, believes the problem of sexual abuse by counsellors to be so serious that earlier this spring it held a conference on the subject, called Broken Boundaries: Sexual and Non-Sexual Boundary Violations in the Psychological Therapies.

“There is a lack of awareness and attention to the issue on the part of practitioners and professional bodies,” says the charity’s chief executive, Jonathan Coe.

“If a therapist is struck off they are legally still allowed to practice. So for even the worst offences there is currently no enforceable sanction. At the moment anyone can set up as a therapist, even without training or experience.”

The only UK study of therapist-patient sexual conduct found that 3.5 per cent of therapists admitted sexual contact with patients. However, Birmingham psychologists Drs Tanya Garrett and John Davis, who conducted the survey of 581 clinical psychologists, think the true figure may well be higher. Almost a quarter of the respondents reported having treated a patient who had been sexually involved with previous therapists. And nearly two-fifths knew of other clinical psychologists who had had sex with patients. “We know that it’s likely that reported levels of abuse by professionals are lower than the actual levels,” says Dr Garrett, who estimates the real figure to more likely be 6 or 7 per cent.

Most perpetrators are men and their victims female. There have been incidents of same-sex pairings, as well as adults sexually abusing child patients. The Birmingham psychologists found that therapists who had themselves undergone therapy were more likely to have sex with patients, and that single or divorced therapists were more likely to start a sexual relationship than married ones.

Research has also found that victims often suffer from borderline personality disorder. Typically they have been sexually abused, and may be over-demanding and have intense relationships because they fear being abandoned.

The impact on patients can be devastating. Some are so traumatised they attempt suicide. Often they are re-hospitalised. Research also suggests they can be vulnerable to being abused again by another mental health professional.

Even if a counsellor belongs to a therapeutic association, has a fancy address and is endorsed by celebrities there is no guarantee he or she will behave honourably. Last year therapist Beechy Colclough, whose clients have included Elton John, Michael Jackson, Robbie Williams and Kate Moss, was exposed for having affairs with women patients in his Harley Street consulting room. One of his victims, Janet Bell, started seeing him in private practice in 1999 for binge drinking. After six months he offered to massage her shoulders when she complained of a bad back. The massages became more intimate. After about a year of therapy they had sex for the first time. “I was lying naked on the floor on big square cushions and he was massaging me,” she says. “He just did it, and I didn’t try and stop him. I should have ended it there and then, but, bizarrely, his wanting to have sex with me made me feel special. I was so in need of affection at the time, I think I would have taken anything.”

They had sex during most sessions until the end of 2002, when she texted him to say she was not coming back. She never heard from him again. She filed a complaint with the British Association for Counselling and Psychotherapy (BACP). He is no longer a member. “What he did is little better than abuse or rape,” she says.

Doctors can be struck off for having a sexual relationship with a patient. Last October the rules were tightened further when the General Medical Council issued revised guidelines stating that having an affair with a former patient would almost always be viewed as inappropriate, no matter how much time has elapsed since treatment ended. But it is anticipated that counselling and psychotherapy will not be subject to statutory regulation until 2008. In the meantime, while a therapist’s membership of a professional body may be terminated, there is nothing to stop them nailing a new plaque to their front door the following day.

The Council for Healthcare Regulatory Excellence (CHRE) is currently running a one-year project, funded by the Department of Health, to find strategies to minimise abuse of patients by healthcare practitioners. “Professionals will throw back the claim that ‘the patient came onto me’. The theme that runs through all of the sets of guidance is that it’s absolutely and always the professional’s responsibility to set and maintain the boundaries,” says Professor Julie Stone, who heads the CHRE project.

With support from Witness, which has been calling for statutory regulation for over 15 years, Jo Adams reported her counsellor to his governing body, the British Association for Sexual and Relationship Therapy. He is no longer a member. Ms Adams has also started legal proceeding against him in the civil courts. “I know there are lot of people who are suffering in silence. There is help out there,” she says.

Some names have been changed

When healers do harm

* Psychologist Dr Steven Manley, who had sex with a patient claiming it was therapy, was suspended from the British Psychological Society for three years in 2005. He met the woman, known as Mrs W, in a car park. She said he “brainwashed” her into thinking it would help her and charged her £35 for the sessions.

* Colin McLean-Manning was jailed for a year in 2004 for indecently assaulting 12 patients. The mental health nurse got a sexual thrill from brushing their hair and rubbing himself against them. He has since been struck off the nursing register.

* In December 2006 the British Psychological Society suspended Gemma Bouwman for three years after she confessed to a sexual relationship with a former client, Mr JG, who was said to have problems relating to physical and sexual abuse he suffered as a child.

During one of their sessions, he told the psychologist he wanted to have an affair with her. She eventually discharged him so they could see each other non-professionally. She was sacked by the NHS following an internal investigation.

To contact Witness call 08454 500300 or visit www.witnessagainstabuse.org.uk

March 27, 2009

Coming Forward – Breaking the Silence

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Way Too Personal

The temptation and consequences of patient-therapist sex.

WebMD Feature

Secrets, dreams, fears, fantasies — all are shared with the professionals we hire to guide us toward optimal mental health. It’s no surprise that patients often become attracted to their therapists.

But woe to the shrink who allows this attraction to develop into a sexual relationship. In its Code of Conduct, the American Psychological Association (APA) forbids sexual relationships during therapy and for two years after therapy ends. Violating this code can bring expulsion from the APA, a revoked license, and a nasty lawsuit.

Every year, about 17 therapists are expelled or asked to resign from the APA due to sexual misconduct, according to the organization, which began keeping track of the numbers in 1993.

Now, the APA is considering changing its Code of Conduct to forbid post-therapy sexual relationships forever. This means that if a woman runs into her former therapist 10 years later, for example, and the two begin a sexual relationship, the therapist could risk his entire career.

Once Vulnerable, Always Vulnerable

Why such a hard-line attitude? “Because of the possibility of the patient being harmed,” says Rhea Farberman, spokeswoman for the APA. People often arrive at therapy with many concerns, sometimes focusing on sexuality issues and distress about how they were parented, says Farberman. ”These vulnerabilities can remain for a lifetime, and a sexual relationship with a therapist could compound their problems,” she adds.

Furthermore, says San Francisco psychotherapist Dorothea Lack, Ph.D., the process called transference almost always occurs during intensive therapy. This happens when the patient transfers onto the therapist the feelings he or she had for an earlier authority figure, typically a parent. “Transference lingers for life,” she says, which is why a sexual relationship can never be equal, even years after therapy has ended. (Transference is not common, however, in short-term counseling, such as the two to six visits typically provided by managed-care programs.)

A Hug-Free Zone?

Since it’s part of an in-depth review of the Code of Conduct, the APA’s code on sexual relationships won’t change for two to three years, if at all. Members are expected to comment on the proposed change by the end of this year. The final decision will be made by the APA Council of Representatives, which includes its board of directors and state and regional representatives.

But, in the meantime, the issue is stirring up controversy within the ranks of psychologists. The threat of lawsuits, the already strong language in the APA code, and the general litigiousness of society have prompted many therapists to erect barriers between themselves and their patients when it comes to any physical contact. No more hugs for a sobbing patient. No encouraging pats on the back. Even friendly chitchat outside office walls is shunned.

“I used to not have any social contact with former patients for two years, but now I don’t do it at all,” says Lack. “It’s just too controversial.”

The Case for Dual Relationships

But Ofer Zur, Ph.D., a private-practice therapist in Sonoma, CA, is leading a fight to support “dual relationships” — patient-therapist bonds that never turn sexual but are nonetheless close and nurturing. “Most of our clients suffer from detached and cold parents,” he says. “So how can we fathom that detached, cold therapists might be able to heal those wounds?”

He contends that sympathetic hugs very rarely lead to sexual advances, and small-town living has convinced him that you can play on the same softball team with a patient outside the office.

“I believe it’s time for patients to file lawsuits against therapists who act in an indecent, uncaring, or inhumane way when they do not hug a grieving mother or anyone else who is in pain,” he says.

Caution Prevails

But Zur is in the minority. The trend is toward more detachment from therapists, he and Lack agree. How this may affect the therapeutic process will take years to discover.

©1996-2005 WebMD Inc. All rights reserved.
Last Editorial Review: 1/30/2005 11:27:37 PM

Since setting up practice “officially” in 1992, self proclaimed Spiritual Guru and “Master Physician of Tibetan Dur Bon Medicine” “Dr.” Christopher Hansard has been engaging in sexual relations with his students and patients. He has caused a great deal of emotional and psychological harm to most as they endured a grueling grooming process under the guise of “treatment”.

The story of his acquired skills and credentials is a lie, and though his frequent demonstrations of ‘power’ over workshop participants has been translated into his having attained some sort of spiritual enlightenment, this abuse of power, and his manipulation of “charisma” should not be interpreted as anything but extreme narcissism, addictive sexual behaviour, and  possible psychopathy.

Whether you currently reside in Canada, the U.S. or the U.K. please report your experiences and any incidences that occurred within the last 16 to 20 years. Your complaints are still valid, though they may be referred to as a “historical assault”, they will help others whose stories are more recent. So please come forward and report what happened to you to your local police department or the police department nearest to where the incident occured.
Thank you.

Project Sapphire – http://www.met.police.uk/crimes/

Royal Canadian Mounted Police - http://www.rcmp-grc.gc.ca/cont/index-eng.htm

Federal Bureau of Investigation – http://www.fbi.gov/contactus.htm


March 26, 2009

The Emperor’s Tantric Robes – Codes of Secrecy in the cult

This article appeared in the Winter 1996 issue of “Tricycle” magazine;

The Emperor’s Tantric Robes

An Interview with June Campbell on Codes of Secrecy and Silence

Tricycle: Is it your understanding that Kalu Rinpoche broke his vows?

Campbell: I don’t know what his vows were. We never spoke of them. What I do know is that clearly I was not an equal in our relationship. As I understand it, the ideals of tantra are that two people come together in a ritualistic exchange of equally, valued and distinct energies. Ideally, the relationship should be reciprocal, mutual. The female would have to be seen on both sides as being as important as the male in the relationship.

My relationship with Kalu Rinpoche was not a partnership of equals. When it started. I was in my late twenties. He was almost seventy. He controlled the relationship. I was sworn to secrecy. What I am saying is that it was not a formal ritualistic relationship, nor was it the “tantric” relationship that people might like to imagine.

The etymology of the word tantra is similar in Sanskrit and Tibetan. In Sanskrit, the word means loom, or warp, but is understood as the principle underlying everything.

In Tibetan, tantra is known as ju (Tibetan rgyud), which means thread, string, or ‘that which joins things together.”

Tricycle: You ended up feeling sexually exploited? Used for personal indulgence?

Campbell: Obviously at the time and for some years afterwards I didn’t think this. How could I? It would have caused me too much distress to see it in this light. It took me many years of thinking about the whole thing to see it differently, and to begin speaking about my experience. This wasn’t easy. I tried through writing to understand why people rationalize these acts as beneficial, and it made me question a lot of things. I’ve got no doubts now that when a male teacher demands a relationship that involves secret sex, an imbalance of power, threats, and deception, the woman is exploited. You have to ask, “Where does the impulse to hide sexual behavior come from?” Especially if it happens in a system that supposedly values the sexual relationship. Of course, there are those who say they are consensually doing secret “tantric” practices in the belief that it’s helping them become “enlightened,” whatever that means. That’s up to them, and if they’re both saying it, that’s fine.

But there’s a difference between that and the imperative for women not to speak of the fact that they’re having a sexual relationship at all. What’s that all about if it’s not about fear of being found out! And what lies behind that fear? These are the question I had to ask.

Tricycle: You were sworn to secrecy by him?

Campbell: Yes. And by the one other person who knew. A member of his entourage.

Tricycle: What might have happened if you had broken the silence?

Campbell: Well, it was assumed that I wouldn’t. But I was told that in a previous life, the last life before this one, Kalu Rinpoche had a woman who caused trouble by wanting to get closer to him, or by wanting to stay with him longer. She made known her own needs, made her own demands, and he put a spell on her and she died.

Tricycle: Just the way child abusers deal with their victims: “If you tell, something bad will happen to you.

Campbell: Yes, there are many similarities. It instills fear in the context of religion. Put yourself in my
position. If I had refused to cooperate I would still have known something that was threatening to the lama and his followers. Where would I have gone from there? If I’d wanted to talk about it no one would have believed me. Some people don’t believe me now. And what if I’d spoken out and the lama had denied it publicly? Could he still have been my teacher? I don’t think so. As it was I was happy to comply at the time because I thought it was the right thing to do and that it would help me. But I was still very, very isolated and afraid for years to speak about it.

In my own experience, despite the absence of a Tibetan upbringing, there were quite specific motivating factors that helped to keep me silent over many years. These factors were probably similar to those which influenced Tibetan women over the centuries. . . . Firstly, there is no doubt that the secret role into which an unsuspecting woman was drawn bestowed a certain amount of personal prestige, in spite of the fact that there was no public acknowledgment of the woman’s position. Secondly, by participating in intimate activities with someone considered in her own and the Buddhist community’s eyes to be extremely holy, the woman was able to develop a belief that she too was in some way “holy” and the events surrounding her were karmically predisposed. Finally, despite the restrictions imposed on her, most women must have viewed their collusion as “a test of faith,” and an appropriate opportunity perhaps for deepening their knowledge of the dharma and for entering ‘the sacred space.”

Tricycle: There are Westerners who knew you when you were with Kalu Rinpoche, who were also close disciples. They did not explicitly know what was going on at the time, yet some of them say now that they are not surprised by your book, that they “knew” without really knowing and that the sexual behavior of lamas, so-called celibate or not, is so pervasive that, in addition to their respect for your personal integrity, there would be no reason to question your veracity At the same time, students in the West who never knew Kalu Rinpoche are disputing you story. And I have already received phone calls from two Tibetan lamas in the Kalu Rinpoche lineage asking me not to publish any of your work and accusing you of making all this up, saying, in both cases, “this June Campbell had a fantasy of having an affair with Kalu Rinpoche.”

Campbell: Well, it’s not the first time that the “fantasy” argument has been used against women. Freud gave in to the social pressures of his day to suppress the truth about what he knew about sexual abuse and incest, and came up with the “female fantasy” theory, now totally discredited. Of course, it’s understandable that those lamas should react in this way; after all, they knew nothing of what was going on. But I’d rather face up now to people abusing my character than go on denying the truth. In any case, my book isn’t about Kalu Rinpoche. It is about much wider issues than my own personal experience, although obviously the effort to write it came from that experience. I left Tibetan Buddhism thirteen years ago and I spent most of those years thinking about the complexities of what happened. If what I’ve written is dismissed by Buddhists as irrelevant, or a fantasy, or a lie-so be it, it doesn’t bother me. I know that writing the book helped me acknowledge m)r past and come to terms with a lot of difficult feelings. It helped me to understand what happened by myself and on my own terms. No one can tell me that isn’t true.

Tricycle: What advice do you have for women who are currently in the position you were in twenty-five years ago?

Campbell: This is a difficult one. Twenty-five years ago I would only take advice from men in maroon robes called “Rinpoche,” so I imagine women in a similar position today will be very, very unlikely to listen to a middle-aged Scotswoman, especially one who’s just been slandered by Tibetan lamas as being a neurotic liar! Still, you’ve given me the opportunity, so I’d have to say: Don’t agree to a long-term secret relationship; it’s a burden you’ll have to carry all your life, and in the end you’ll have to be true to yourself and face up to why you entered into it. If you’re afraid of what might happen next, or how you’ll deal with the stresses of secrecy, try to take control of your life again. If you’re being passive and compliant because he’s your teacher, do as I did eventually: think for yourself, take action, and end it. Never allow part of yourself to be hidden away under threats of “bad karma” or anything else. The truth never made “bad karma.” If you need to, look for supportive people to help you. If you’ve started to feel that in some way you’re special, that maybe you’ve been chosen to fulfill some kind of destiny, well, think again. These kinds of thoughts won’t help you to become strong in yourself. They may seem to explain things now, but they’ll only hold you back in the long run.

cult_leaders_nprofessionalbanner

The following is an excerpt from the book “Captive Hearts, Captive Minds” by Madeleine Landau
Tobias and Janja Lalich. See other “Resources and Links” for ordering information.

The Master Manipulator

Let us look for a moment at how some of this manifests in the cult leader. Cult leaders have an
outstanding ability to charm and win over followers. They beguile and seduce. They enter a room and garner all the attention. They command the utmost respect and obedience. These are “individuals whose narcissism is so extreme and grandiose that they exist in a kind of splendid isolation in which the creation of the grandiose self takes precedence over legal, moral or interpersonal commitments.”(l8) Paranoia may be evident in simple or elaborate delusions of persecution. Highly suspicious, they may feel conspired against, spied upon or cheated, or maligned by a person, group, or governmental agency. Any real or suspected unfavorable reaction may be interpreted as a deliberate attack upon them or the group. (Considering the criminal nature of some groups and the antisocial behavior of others, some of these fears may have more of a basis in reality than delusion!)

Harder to evaluate, of course, is whether these leaders’ belief in their magical powers, omnipotence, and connection to God (or whatever higher power or belief system they are espousing) is delusional or simply part of the con. Megalomania–the belief that one is able or entitled to rule the world–is equally hard to evaluate without psychological testing of the in- dividual, although numerous cult leaders state quite readily that their goal is to rule the world. In any case, beneath the surface gloss of intelligence, charm, and professed humility seethes an inner world of rage, depression, and fear.

Two writers on the subject used the label “Trust Bandit” to describe the psychopathic personality.(l9) Trust Bandit is indeed an apt descripdon of this thief of our hearts, souls, minds, bodies, and pocketbooks. Since a significant percentage of current and former cult members have been in more than one cultic group or relationship, learning to recognize the per- sonality style of the Trust Bandit can be a useful antidote to further abuse.

The Profile of a Psychopath

In reading the profile, bear in mind the three characteristics that Robert Lifton sees as common to a cultic situation:

1. A charismatic leader who…increasingly becomes the object of worship

2. A series of processes that can be associated with “coercive persuasion” or “thought reform”

3. The tendency toward manipulation from above…with exploitation–economic, sexual, or other–of often genuine seekers who bring idealism from below(20)

Based on the psychopathy checklists of Hervey Cleckley and Robert Hare, we now explore certain traits that are particularly pertinent to cult leaders. The 15 characteristics outlined below list features commonly found in those who become perpetrators of psychological and physical abuse. In the discussion we use the nomenclature “psychopath” and “cult leader” interchangeably. To illustrate these points, a case study of Branch Davidian cult leader David Koresh follows this section.

We are not suggesting that all cult leaders are psychopaths but rather that they may exhibit many of the behavioral characteristics of one. We are also not proposing that you use this checklist to make a diagnosis, which is something only a trained professional can do. We present the checklist as a tool to help you label and demystify traits you may have noticed in your leader.

Characteristics of a Cult Leader

People coming out of a cultic group or relationship often struggle with the question, “Why would anyone (my leader, my lover, my teacher) do this to me?” When the deception and exploitation become clear, the enormous unfairness of the victimization and abuse can be very difficult to accept. Those who have been part of such a nightmare often have difficulty placing the blame where it belongs–on the leader.

A cult cannot be truly explored or understood without understanding its leader. A cult’s formation,
proselytizing methods, and means of control “are determined by certain salient personality characteristics of [the] cult leader….Such individuals are authoritarian personalities who attempt to compensate for their deep, intense feelings of inferiority, insecurity, and hostility by forming cultic groups primarily to attract those whom they can psychologically coerce into and keep in a passive-submissive state, and secondarily to use them to increase their income.”(l)

In examining the motives and activities of these self-proclaimed leaders, it becomes painfully obvious that cult life is rarely pleasant for the disciple and breeds abuses of all sorts. As a defense against the high level of anxiety that accompanies being so acutely powerless, people in cults often assume a stance of self-blame. This is reinforced by the group’s ma- manipulative messages that the followers are never good enough and are to blame for everything that goes wrong.

Demystifying the guru’s power is an important part of the psyche- educational process needed to fully recover.(2) It is critical to truly gaining freedom and independence from the leader”s control. The process starts with some basic questions: Who was this person who encouraged you to view him as God, all-knowing, or all-powerful? What did he get out of this masquerade? What was the real purpose of the group (or relationship)?

In cults and abusive relationships, those in a subordinate position usually come to accept the abuse as their fault, believing that they deserve the foul treatment or that it is for their own good. They sometimes persist in believing that they are bad rather than considering that the person upon whom they are so dependent is cruel, untrustworthy, and unreliable. It is simply too frightening for them to do that: it threatens the balance of power and means risking total rejection, loss, and perhaps even death of self or loved ones.
This explains why an abused cult follower may become disenchanted with the relationship or the group yet continue to believe in the teachings, goodness, and power of the leader.

Even after leaving the group or relationship, many former devotees carry a burden of guilt and shame while they continue to regard their former leader as paternal, all-good, and godlike. This is quite common in those who “walk away” from their groups, especially if they never seek the benefits of an exit counseling or therapy to deal with cult-related issues. This same phenomenon is found in battered women and in children who are abused by their parents or other adults they admire.

To heal from a traumatic experience of this type, it is important to understand who and what the
perpetrator is. As long as there are illusions about the leader’s motivation, powers, and abilities, those who have been in his grip deprive themselves of an important opportunity for growth: the chance to empower themselves, to become free of the tyranny of dependency on others for their well-being, spiritual growth, and happiness.

The Authoritarian Power Dynamic

The purpose of a cult (whether group or one-on-one) is to serve the emotional, financial, sexual, and power needs of the leader. The single most important word here is power. The dynamic around which cults are formed is similar to that of other power relationships and is essentially ultra- auhoritarian, based on a power imbalance. The cult leader by definition must have an authoritarian personality in order to fulfill his half of the power dynamic. Traditional elements of authoritarian personalities indude the following:

-the tendency to hierarchy

-the drive for power (and wealth)

-hostility, hatred, prejudice

- superficial judgments of people and events

-a one-sided scale of values favoring the one in power

-interpreting kindness as weakness

-the tendency to use people and see others as inferior

-a sadistic-masochistic tendency

-incapability of being ultimately satisfied

-paranoia(3)

In a study of twentieth-century dictators, one researcher wrote: ‘Since compliance depends on whether the leader is perceived as being both powerful and knowing, the ever-watchful and all-powerful leader and his invisible but observant and powerful instruments, such as secret police) can be invoked in the same way as an unobservable but omniscient God….Similarly, the pomp and ceremony surrounding such an individual make him more admirable and less like the common herd, increasing both his self-confidence and the confidence of his subjects. The phenomenon is found not only with individual leaders, but with entire movemnts”(4)

We will see, however, that an authoritarian personality is just one aspect of the nature of a cult leader.

Who Becomes a Cult Leader?

Frequently at gatherings of former cult members a lively exchange takes place in which those present compare their respective groups and leaders. As people begin to describe their special, enlightened, and unique “guru”–be he a pastor, therapist, political leader, teacher, lover, or swami–they are quickly surprised to find that their once-revered leaders are really quite similar in temperament and personality. It often seems as if these leaders come tiom a common mold, sometimes jokingly called the “Cookie-cutter Messiah School.”

These similarities between cult leaders of all stripes are in fact character disorders commonly identified with the psychopathic personality. They have been studied by psychiatrists, medical doctors, clinical psychologists, and others for more than half a century. In this chapter we review some of this research and conclude with a psychopathological profile of traits commonly found in abusive leaders.

Cultic groups usually originate with a living leader who is believed to be “god” or godlike by a cadre of dedicated believers. Along with a dra- matic and convincing talent for self-expression, these leaders have an intuitive ability to sense their followers’ needs and draw them closer with promises of fulfillment.
Gradually, the leader inculcates the group with his own private ideology (or craziness!), then creates
conditions so that his victims cannot or dare not test his claims. How can you prove someone is not the Messiah? That the world won’t end tomorrow? That humans are not possessed by aliens from another world or dimension? Through psychological manipulation and control, cult leaders trick their followers into believing in something, then prevent them from testing and disproving that mythology or belief system.

The Role of Charisma

In general, charismatic personalities are known for their inescapable magnetism, their winning style, the self-assurance with which they promote something–a cause, a belief, a product. A charismatic person who offers hope of new beginnings often attracts attention and a following. Over the years we have witnessed this in the likes of Dale Carnegie, Werner Erhard (founder of est, now The Forum), John Hanley (founder of Lifespring), Maharishi Mahesh Yogi, Shirley MacLaine, John Bradshaw, Marianne Williamson, Ramtha channeler J.Z. Knight, and a rash of Amway “executives,” weight-loss program promoters and body-building gurus.

One dictionary definition of charisma is “a personal magic of leadership arousing special popular loyalty or enthusiasm for a public figure (as a political leader or military commander); a special magnetic charm or appeal.”(5) Charisma was studied in depth by the German sociologist Max Weber, who defined it as “an exceptional quality in an individual who, through appearing to possess supernatural, providential, or extraordinary powers, succeeds in gathering disciples around him.”(6)

Weber’s charismatic leader was “a sorcerer with an innovative aura and a personal magnetic gift, [who] promoted a specific doctrine…. [and was] concerned with himself rather than involved with others….[He] held an exceptional type of power: it set aside the usages of normal political life and assumed instead those of demagoguery, dictatorship, or revo- lution, [which induced] men’s whole-hearted devotion to the charismatic individual through a blind and fanatical trust and an unrestrained and un- critical faith.”(7)

In the case of cults, of course, we know that this induction of whole hearted devotion does not happen spontaneously but is the result of the cult leader’s skillful use of thought-reform techniques. Charisma on its own is not evil and does not necessarily breed a cult leader. Charisma is, however, a powerful and awesome attribute found in many cult leaders who use it in ways that are both self-serving and destructive to others. The combination of charisma and psychopathy is a lethal mixture–perhaps it is the very recipe used at the Cookie-cutter Messiah School!

For the cult leader, having charisma is perhaps most useful during the stage of cult formation. It takes a strong-willed and persuasive leader to convince people of a new belief, then gather the newly converted around him as devoted followers. A misinterpretation of the cult leader’s personal charisma may also foster his followers’ belief in his special or messianic qualities.

So we see that charisma is indeed a desirable trait for someone who wishes to attract a following.
However, like beauty, charisma is in the eye of the beholder. Mary, for example, may be completely taken with a par- ticular seminar leader, practically swooning at his every word, while her friend Susie doesn’t feel the slightest tingle. Cehtainly at the time a person is under the sway of charisma the effect is very real. Yet, in reality, charisma does nothing more than create a certain worshipful reaction to an idealized figure in the mind of the one who is smitten.

In the long run, skills of persuasion (which may or may not be charismadc) are more important to the cult leader than charisma–for the power and hold of cults depend on the particular environment shaped by the thought-reform program and control mechanisms, all of which are usually conceptualized and put in place by the leader. Thus it is the psychopathology of the leader, not his charisma, that causes the systematic manipulative abuse and exploitation found in cults.

The Cult Leader as Psychopath

Cultic groups and relationships are formed primarily to meet specific emotional needs of the leader, many of whom suffer from one or another unotional or character disorder. Few, if any, cult leaders subject them- selves to the psychological tests or prolonged clinical interviews that allow for an accurate diagnosis.
However, researchers and clinicians who have observed these individuals describe them variously as neurotic, psychotic, on a spectrum exhibiting neurotic, sociopathic, and psychotic characteristics, or suffering from a diagnosed personality disorder.(8)

It is not our intent here to make an overarching diagnosis, nor do we intend to imply that ah cult leaders or the leaders of any of the groups mentioned here are psychopaths. In reviewing the data, however, we can surmise that there is significant psychological dysfunctioning in some cult leaders and that their behavior demonstrates features rather consistent with the disorder known as psychopathy.

Dr. Robert Hare, one of the world’s foremost experts in the field, estimates that there are at least two million psychopaths in North America. He writes, “Psychopaths are social predators who charm, manipulate, and ruthlessly plow their way through life, leaving a broad trail of broken hearts, shattered expectations, and empty wallets. Completely lacking in conscience and in feelings for others, they selfishly take what they want and do as they please, violating social norms and expectations without the slightest sense of guilt or regret.”(9)

Psychopathy falls within the section on personality disorders in the Diagnostic and Statistical Manual of Mental Disorders, which is the standard source book used in making psychiatric evaluations and
diagnoses.(l0) In the draft version of the manual’s 4th edition (to be released Spring 1994), this disorder is listed as “personality disorder not otherwise specified/Cleckley-type psychopath,” named after psychiatrist Hervey Cleckley who carried out the first major studies of psychopaths. The combination of personality and behavioral traits that allows for this diagnosis must be evident in the person’s history, not simply apparent during a particular episode. That is, psychopathy is a long-term personality disorder. The term psychopath is often used interchangeably with sociopath, or sociopathic personality Because it is more commonly recognized, we use the term psychopath here.

Personality disorders, as a diagnosis, relate to certain inflexible and maladaptive behaviors and traits that cause a person to have significantly impaired social or occupational functioning. Signs of this are often first manifested in childhood and adolescence, and are expressed through distorted patterns of perceiving, relating to, and thinking about the environment and oneself. In simple terms this means that something is amiss, awry, not quite right in the person, and this creates problems in how he or she relates to the rest of the world. 6

The psychopathic personality is sometimes confused with the “anti- social personality,” another disorder; however, the psychopath exhibits more extreme behavior than the antisocial personality. The antisocial per- sonality is identified by a mix of antisocial and criminal behaviors–he is the common criminal. The psychopath, on the other hand, is characterized by a mix of criminal and socially deviant behavior.

Psychopathy is not the same as psychosis either. The latter is characterized by an inability to differentiate what is real from what is imagined: boundaries between self and others are lost, and critical thinking is greatly impaired. While generally not psychotic, cult leaders may experience psychotic episodes, which may lead to the destruction of themselves or the group. An extreme example of this is the mass murder-suicide that occurred in November 1978 in Tonestown, Guyana, at the People’s Temple led by Jim Jones. On his orders, over 900 men,women, and children perished as Jones deteriorated into what was probably a paranoid psychosis.

The psychopathic personality has been well described by Hervey ClecMey in his classic work, The Mask of Sanity, first published in 1941 and updated and reissued in 1982. Cleckley is perhaps best known for The Three Faces of Eve, a book and later a popular movie on multiple personal- ity. Cleckley also gave the world a detailed study of the personality and behavior of the psychopath, listing 16 characteristics to be used in evaluating and treating psychopaths.(ll)

Cledde’s work greatly influenced 20 years of research carried out by Robert Hare at the University of British Columbia in Vancouver. In his work developing reliable and valid procedures for assessing psychopathy, Hare made several revisions in Cleddey’s list of traits and finally settled on a 20-item Psychopathy Cheddist.(l2) Later in this chapter we will use an adaptation of both the Cleddey and Hare checklists to examine the profile of a cult ieader.

Neuropsychiatrist Richard M. Restak stated, “At the heart of the di- agnosis of psychopathy was the recognition that a person could appear normal and yet dose observation would reveal the personality to be irra- tional or even violent.”(l3) Indeed, initially most psychopaths appear quite normal. They present themselves to us as charming, interesting, even humble. The majority “don’t suffer from delusions, hallucinations, or memory impairment, their contact with reality appears solid.”(l4) Some, on the other hand, may demonstrate marked paranoia and megalomania. In one clinical study of psychopathic inpatients, the authors wroa: “We found that our psychopaths were similar to normals (in the reference group) with regard to their capacity to experience external event~ as real and with regard to their sense of bodily reality. They generally had good memory, concentration attention, and language function. They had a high barrier against external, aversive stimulation….In some ways they dearly resemble normal people and can thus ‘pass’ as reasonably normal or sane. Yet we found them to be extremely primitive in other ways, even more primitive than frankly schizophrenic patients. In some ways their thinking was sane and reasonable, but in others it was psychotically inefficient and/or convoluted.”(l5)

Another researcher described psychopaths in this way: “These people are impulsive, unable to tolerate frustration and delay, and have problems with trusting. They take a paranoid position or externalize their emotional experience. They have little ability to form a working alliance and a poor capacity for self-observation. Their anger is frightening. Frequently they take flight. Their relations with others are highly problematic. When dose to another person they fear engulfment or fusion or loss of self. At the same time, paradoxically, they desire closeness; frustration of their entitled wishes to be nourished, cared for, and assisted often leads to rage. They are capable of a child’s primitive fury enacted with an adult’s physical – capabilities, and action is always in the offing.$l6)

Ultimately, “the psychopath must have what he wants, no matter what the cost to those in his way.”(l7)

March 23, 2009

Patient Abuse by Therapists

From Lawyers Weekly USA.

Feature Story

Small Firm Specializes In Patient Abuse By Therapists
Far More Common Than Many Suspect

By Elaine McArdle

In the late 1970s, Stanley J. Spero was a successful trial lawyer in Cambridge, Mass., with a typical roster of medical malpractice and auto product liability cases. That all changed when a deeply troubled young woman with a history of serious psychiatric problems told him that her psychiatrist had sexually abused her numerous times.

At the time, no one had ever successfully sued a therapist in Massachusetts for sexual abuse of a patient – and Spero’s colleague Linda M. Jorgenson, who later became his law partner, had strong doubts about the case. The woman was a bi-polar schizophrenic and delusional; at one point, when they visited her in a mental hospital, she claimed George Washington had just dropped by.

“I’m embarrassed to say this now,” recalled Jorgenson, “but I told Stan, ‘You really want to be sure she’s telling the truth.’ She was very, very ill.”

But Spero was certain that, in spite of her many delusions, the woman was telling the truth about her therapist.

“What made me decide to take the case is one of my strengths and weaknesses,” he said. “I’m terribly sensitive to people being abused. Just because they have psychiatric problems doesn’t mean they’re not telling the truth.”

Jorgenson, however, remained unconvinced. Her opinion didn’t change until she reluctantly agreed to take the deposition of a doctor who treated the woman after the defendant psychiatrist.

“I asked him, ‘Why do you believe what this woman is saying?’ And he said, ‘Because when I called up the psychiatrist, he told me he did it.’”

Jorgenson shakes her head at the memory, saying that she “decided at that moment” that she would never again doubt a victim’s story without looking into the matter further.

Spero and Jorgenson set state precedent in 1983 when they won a $280,000 verdict against the psychiatrist. Since then, the team – who formally became partners in 1993 – have handled more than 400 cases of therapist abuse throughout the country and become national experts on the issue.

The five-lawyer firm currently has about 100 open cases a year, most of which settle for between $300,000 and $500,000. But if a case goes to trial the typical verdict is substantially larger. They’ve settled dozens of cases for more than $1 million, including a recent $1.7 million confidential settlement against a psychologist in a Western state, and they’ve landed dozens of verdicts of similar size.

“From that first case, it just turned into an incredible thing, as more and more people realized they had rights,” said Spero.

Therapist abuse cases are plentiful, he noted. According to a national survey published in 1986 in the American Journal of Psychiatry, between 7 and 12 percent of therapists admit having sexual contact with one or more patients. Eighty to 90 percent of therapist abuse cases involved female victims, the partners note, usually with male therapists. Some therapists are serial predators, others may stray just once.

Studies have demonstrated irrefutable harm to most patients who enter into a sexual relationship with a therapist, including depression, isolation, relationship difficulties, and increased risk of suicide. For that reason, professional ethics strictly forbid therapists from having any sexual contact with patients, and for psychiatrists, the restrictions are even greater: they are forbidden from sexual contact with former patients, too.

Twenty-four states regard therapist-patient sex as a criminal act, because the power imbalance in the relationship makes it impossible for the patient to voluntarily consent. And in almost all states, proof of a sexual relationship with a patient will result in the therapist losing his license.

“The sex act itself isn’t necessarily the damaging part,” said Spero. “It’s the invasion of all kinds of boundaries, and the violation of trust.”

“It doesn’t matter if the therapist thinks he’s in love or not,” added Jorgenson. “They should never have sex with a patient. It displaces the primary purpose of the relationship, which is to treat that patient so that they can have healthy relationships with other people.”

The first order of business when trying these cases is to get a jury to understand these aren’t about consensual affairs.

“This is about a doctor’s fiduciary duty to the patient, and the fact that this duty has been violated,” said Spero.

Different From Medical Malpractice

Therapist abuse cases carry their own peculiarities of law and trial strategy, the partners note.

Defendants almost always deny that sexual contact occurred. Since the victims suffer from emotional or psychiatric problems while the defendants are well-spoken, educated physicians or psychologists, it’s critical to have corroborating evidence such as telephone records, hotel receipts, witnesses who’ve seen the therapist and patient together in social settings, gifts, or love letters.

For their first case, the one involving the bipolar woman, Spero and Jorgenson located a nurse who recalled the defendant psychiatrist visiting the victim’s hospital room at odd hours. They also found neighbors who testified they saw the doctor’s car at the victim’s home. Without this kind of evidence, it’s almost impossible to win what amounts to a she said/he said contest.

Spero and Jorgenson are currently suing the former director of psychiatry at a major Massachusetts hospital on behalf of two female victims. In that case, the doctor snapped nude photographs of one patient and had her take his photo, too, which shows him naked beneath his framed Yale medical degree, wearing nothing but a black condom that reads “lollipop.”

But it’s rare to have such clear-cut evidence.

“We say to the clients, ‘It’s your word against his. Do you have something to back you up?’” said Spero. “They have to understand how severe the risk is, and how intrusive these cases are. They’re going up against a person who comes cloaked with a professional degree.”

Defense attorneys delve into the victim’s psychiatric history and every other aspect of his or her life – family relationships, romantic history, work failures – all touchy matters that often are the reason the person went into therapy in the first place.

“It’s a very different kind of litigation,” said Spero. “With regard to the revealing of intimacies and the invasion of privacy, nothing in med-mal compares to it.”

The statute of limitations – three years, in most states – often kills many potential cases. But Spero again set precedent in Massachusetts in 1991 in Riley v. Presnell, which recognized that many plaintiffs don’t realize until long after the incident that what the therapist did was harmful. (565 N.E.2d 780)

In the Riley case, the male plaintiff began therapy with Dr. Presnell, a male psychiatrist at Harvard who gave him alcohol and drugs and later engaged him in sex.

“Riley could never understand anything was wrong,” said Jorgenson. “He was told this was good for him, that it was treatment, so he continued.”

It wasn’t until another young patient revealed that Dr. Presnell had sex with him, too, that Riley thought something might be amiss.

The defendant won summary judgment based on the contention that the statute of limitations had run out. But Spero and Jorgenson appealed the case to the Massachusetts Supreme Judicial Court, which changed the standard for determining when the patient “discovered” the abuse, and thus when the statute of limitations begins to run. Today, it is up to the jury to decide when the statute begins to run by determining when the plaintiff knew or should have known that the sexualization of the relationship was improper.

“It was a good decision for the victims. It recognizes that for some victims, it takes years to realize what happened,” said Jorgenson. “A lot of them regard it as an affair. They never think that their inability to sleep at night or their depression is connected to this relationship [with the therapist].”

Another problem is insurance coverage. Most malpractice policies do not cover sexual abuse of patients, so the plaintiffs must pursue a defendant’s assets, which is time-consuming and sometimes fruitless.

And these cases have much more emotional impact on the victims than typical medical-malpractice matters, the partners note. Often the plaintiffs have deeply mixed feelings about suing.

“Their self-blame is so powerful,” Spero said. “They can hear every expert support them, and still they blame themselves. People don’t like to feel they were victims.”

It’s hard on the lawyers, too.

“This litigation is so intense, very few lawyers could tolerate it,” Spero said. “You have to spend a lot of time with the clients, where in a regular med-mal, your time is with the expert witnesses.”

Spero typically spends a full day or longer on the initial interview with the client, getting to know her, garnering her trust, and determining whether she is credible.

Few cases ever get to the jury. Once there is credible evidence that a sexual relationship took place, defendants typically settle, since such behavior is a clear violation of medical ethics. The partners have lost just one jury trial, in a case involving a male patient and a female therapist who was a drug counselor, where the judge was clearly not sympathetic to the cause of action, Spero recalled.

“We’ve had other cases with male clients and female therapists, and except for a couple of them, all they wanted was their money back for the therapy,” said Jorgenson. Male clients often are embarrassed to paint the relationship as anything but positive, she believes.

Important Work

Many victims say their primary goal in these lawsuits is to protect other patients from a doctor’s abuse, Spero said.

“We have so many come in here where they don’t even want to know the value of their case,” he said.

Often, clients choose not to sue civilly. Instead, they testify before the state board that licenses the therapist, hoping to see his license revoked.

Spero and Jorgenson believe therapists should be required to inform patients, at the start of therapy, that sex is never an appropriate part of the therapeutic relationship. They also believe all therapists should be required to meet regularly with a supervisor or a peer group, to discuss whether a patient relationship is becoming too personal and, if so, to get help.

Jorgenson continues her efforts to pass legislation in every state that criminalizes this behavior. In the meantime, the firm has a heavy caseload and continues to get calls from all over the country. But Jorgenson believes that things are slowing slightly, in large part because public awareness of the issue is making it harder for therapists to abuse their patients.

Both lawyers find the work deeply satisfying.

“I don’t see how you can’t feel good about it,” said Jorgenson. “In so many kinds of cases, like divorce, you really could take either side. But here there is clearly only one right side.”

Spero saves the letters that his clients send him, thanking him for his help.

“I want my children to know that you can make a difference in this world. Not always a big difference, but in your own way,” he said. “I know we’ve made a dent in this problem.”

Questions or comments can be directed to the features editor at: bibelle@lawyersweekly.com

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March 20, 2009

Master Physician of Tibetan Dur Bon Medicine

The Metropolitan Police has received information concerning the practice of Tibetan Dur Bon Medicine within London and the possibility that certain, as yet unknown individuals, may have fallen victim to assault whilst receiving such treatment.

If you are the victim or witness to such a crime, please contact the Metropolitan Police at Project Sapphire, Territorial Police Headquarters, Victoria Embankment, London, SW1. Tel: 020 7321 7384. E-mail: sapphire@met.police.uk

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