Monthly Archives: October 2014
Which brings us to the matter of AB 1775, a new state law which will go into effect in January 2015, which will compel psychotherapists and other mandated reporters of child abuse, to report to police or social services individuals who view child pornography, which is defined as images depicting minors’ sexuality (therefore including teens sending nude pictures). Those who wrote this bill did so in consultation with law enforcement officials such as the Sheriff’s association, and child advocacy groups, not psychotherapists or other similar professionals who are trained to listen to disclosures of disturbing personal information and to facilitate interventions. Most therapists in California became familiar with the bill just three months ago, just one month prior to the bill’s signing by governor Brown, through the California Association for Marriage and Family Therapists (CAMFT), which sanctioned the bill with little or no information provided to the membership, and with only short notice as to the bill’s significance.
A statement by the bill’s author: “AB 1775 will further ensure the protection of children from the proliferation of sexual exploitation through internet child pornography. The State Legislature has a duty to ensure it does everything within its power to make certain the most vulnerable of our society, our children, are protected.” Given the demagogic politics of this language, it’s going to be almost impossible to have this law amended, much less have it repealed. Proponents needn’t even substantiate the claim that children will be protected by this legislation, though one might think that some within the ranks might question how this will work. After all, has making drugs illegal protected kids from drug abuse? Are mass arrests of pot smokers and crackheads exposing a trail of clues leading authorities to drug cartels, thus protecting society from the deadly scourge of addiction? How’s that plan coming along? Meanwhile, how many more reports to social services agencies will be generated by this law? Is the funding and thus the staffing there to field all these new reports? How many of these reports will lead to fuller investigations, arrests and incarcerations? And if these aren’t necessarily the intended consequences, then how many therapeutic alliances (between clients and therapists) will be unnecessarily disrupted–a fragile trust destroyed–by a therapist’s informant duties?
A colleague within CAMFT, a man interested in solutions more so than argument, has proposed a compromise: a plan to keep the overall rule with respect to AB 1775 in place but to advocate for mental health professionals to be an exception to the mandatory disclosure. The bill currently includes a huge list of mandated reporters, including such non-qualified persons as coaches, probation officers, “head start” teachers–people not trained to address or treat mental health conditions. I can sympathize with the argument that if these people discover that someone is viewing child pornography then their best course of action may be to report the event to social services. However, one could make the argument that the best thing for offenders is to talk to a mental health professional in the hope of obtaining early intervention before someone is hurt more directly. **BTW: this argument does not imply that child subjects in pornography are not victims (as in “hurt”), merely that such damage is not inflicted directly by those viewing the images.
And if you want to have the conversation about such viewers enabling child pornographers/exploiters of children, thus deserving any punishment they might receive, then we must have consistent intellectual honesty and talk about how our entire consumer economy exists on the back of unfair labor practices across the world. If you’re not sure what I’m getting at then get out your precious new I-phone 6, contemplate its manufacturing and assembly of parts, imagine the wages earned by those responsible, and consider trading jobs with the adults and children that are performing that work.
Regarding amendments and AB 1775, it probably won’t matter what gets proposed. As CAMFT (committing, perhaps, its own version of political suicide) has implied through its action, involved discussion is moot and inexpedient. Fifty years ago, legislators wanted private exchanges revealed such that communists could be pulled from their closets. Ten years ago the Patriot Act extended its tentacles into the therapist’s office, mandating professionals to report those suspected of terrorist acts. There will always be a core of people in society who will fundamentally resist the confidentiality of institutions, religious or secular. As therapists, we know that the media, that the NSA, that parents, Apple and AT&T, all want in the room so they can hear, direct, and sell. They want in so they can do everything except really listen, actually.
By now many readers will be familiar with the controversy surrounding actor Stephen Collins, whose divorcing wife surreptitiously taped a couples therapy session in which Collins confesses to the past molestation of an 11 year old girl. While some (mostly professionals) are disturbed by the violation of confidentiality issue, most of the trolling comments in social media seem biased towards the end that justifies the means: the outing of a child sexual abuser.
The cacophony of wrongness is so loud that I wonder if there’s room for a thoughtful, informed breakdown of the issues. As a psychotherapist, I’ve come across many situations wherein child abuse (sexual and not) is suspected, and I’ve further worked with sex offenders who are mandated through the legal system to seek counseling. There are misconceptions about the treatment of these cases, one of which surrounds the reporting requirements of the mental health professional. For example, in the case of Collins’ alleged victim, many have wondered why the therapist in question didn’t report Collins’ confession to either the police or a social services agency, as would have been his or her prerogative. But not necessarily an obligation. It’s unclear from the story if the 11 year old in question is still a minor, and in such cases where the alleged victim is an adult at the point of disclosure, the therapist actually has discretion under the law. He or she must actually determine if an ongoing risk to a child is present, and then make a report.
What happens next? Well, in ordinary abuse cases, an investigation happens, possibly followed by arrest or a suspension of custody or contact rights for the alleged abuser: a disruptive, frightening, if sometimes necessary experience for everyone involved, especially children and parents. The matter of the therapist’s report is generally private–meaning, a matter between therapist and client. If the person who is reported is disgruntled with the therapist for making the report, he or she can fire that person or work through the conflict and continue the therapy. This is not the case with respect to child sexual abuse, or with respect to sex offenses that do not involve children. As many are aware, those who are convicted of sexual offenses are placed upon a public registry, and their designation as sexual offenders is lifelong. (BTW: the list of what constitutes a sexual offense is long and varied, and if you think teens sending ‘selfies’ are exempt, think again). If directed to counseling in California, an individual must find a therapist credentialed by a government body called the California Sex Offender Management Board (CASOMB), which provides guidelines for the treatment of sex offenders–guidelines that compromise bedrock principles of psychotherapy, especially those pertaining to confidentiality.
So, if a therapist reports a client for child sexual abuse and has not chosen to credential (no small task, actually) with CASOMB, their work with the person they’ve reported will soon be over. This is not the case with respect to all other mandated report situations–a truism not understood by many therapists. CASOMB compels treatment guidelines involving regular reports to CASOMB-partnered officials, following a premise echoed on social media: that pedophiles are not treatable. This is the kind glib drivel that has been asserted about several diagnostic or assessment categories in the past, including addictions, borderline personality, and schizophrenia–assertions that have since been debunked. What the reader should understand is that research into “what is effective” mental health treatment is often shallow, unconvincing, and contaminated by the interests of the insurance and pharmaceutical industries, not to mention providers offering competing models of care. How do you know if a treatment approach for, say, ADHD, is demonstrably effective? Because a study by university X conducted 3-6 months after a treatment protocol is applied to sample of subjects indicates a significant “reduction” of problem behaviors, as defined by the study. Note the time frame and the word reduction. These criteria are central to research into conditions like depression, anxiety, ADHD, behaviors like substance abuse. Now consider child sexual abuse, so-called pedophilia: would you, the apparent consumer of mental health research, be satisfied with such short-term time frames of study? Would you satisfied to hear that a child abuser’s behavior has “reduced”.
My point is not to inflame the passions of those brandishing pitchforks and torches, ready of lynch sex offenders, or throw them in jail and throw away the key–yada, yada, yada. My point is to rebuke the casual invoking of research to sell an arbitrary standard of care. In part two of this article, I will further an argument for the importance of confidentiality in mental health treatment, and protest against those ignorant legislators and self-appointed advocates who are unknowingly working against their own cause.
**click title for image
Having some difficulty with the novel, The Situation. Some of you are reading it, for which I am grateful, but some of you are not getting it, about which I am…hmm…chagrinned, to put it politely. I know. I’m a whining, narcissistic author, starved of understanding. I should accept the partial appreciations I am receiving, the enjoyment some are having, taking what they like, as they say in 12-step programs, and–and the corollary is huge–leaving the rest.
To hell with that.
I wrote both CFTH and The Situation, for various reasons: 1.) to express myself creatively, 2.) to entertain, and 3.) to teach something important as an adjunct to my psychotherapy practice, which happens privately, behind closed doors, thus generating a need to venture outwards. There are in my novels several themes of note, and as my own process is sometimes unconscious, I can’t account for them all. Not that I don’t try, so here’s a rough list of succinctly-termed ideas present in the text and subtext: addiction, trauma, the tyranny of workplaces, of secrets within closed systems, like workplaces and families; about the ubiquity of dissociation, of impotence, and indifference; about the distance of friends, the lingering power of the absent, and the tense battles between lovers, for each self to fit in.
I guess that should be enough, but especially for The Situation–the follow-up and coup de grace–there needed to be something special (not to mention positive), something to make sense of, tie together the story as a whole. Empathy. That was the quality–the redemptive, sobriety-supporting (as one reader puts it) quality–that came to mind, as the point. And so, the novel delivers a climax with empathy as its thematic core, and everyone, author, characters and readers alike, should get the point and transport said point, somehow, back to our (or their) daily lives. And they seem to, those supportive few. But there are clues along the way–words unfortunately skipped, I suspect–that are getting missed; and it’s important. Why? Because you might notice something in relationships as in art: you shouldn’t miss the details.
Anyway, much misunderstanding centers around a contentious section of Situation, entitled “Nightmare”. Bryan “Weed” Tecco, my cardboard villain from CFTH, referenced only in his absence in that novel, is thereafter my protagonist, and he’s alive, contrary to the suppositions of my other characters, and in all likelihood, readers of CFTH. Emerging not-quite drowned from a lagoon in West Marin, he holes up at an old friend’s house in villagy Bolinas, then hitchhikes back to suburbia, only to be picked up and later drugged by a man, Dan Pritchard, with a sadistic streak and an apparent diaper fetish. Apart from recalling Chris Leavitt’s wayward new diaper invention from the first novel, the notion here is to have my character make a psychic return to helplessness: to a time when all needs are taken care of (and Dan Pritchard does take care); to a time when the body is uninhibited; to a time when the mind is bewildered, and possibly terrified. Weed is humiliated by Dan Pritchard, and though he appears to escape uninjured, there lingers the suggestion that Weed has been violated, while asleep no less.
Attentive readers, those who stuck with the various backstories of CFTH, may think this just desserts, this victimization. After all, according to Chris Leavitt, Weed introduced friends like Chris to not only a drug using lifestyle, but also a milieu in which prostitutes, sex, and consent for sex, moves freely (from one POV), or inchoately, dissociatively (from another). Regardless, I had plans for Bryan “Weed” Tecco–plans to make him an unlikely hero, back from the dead, but more importantly, back from infamy and indifference. In the chapters that follow “Nightmare”, Weed resolves not to talk about his ordeal with Dan Pritchard, but as many in my practice have discovered, not talking about something far from means that one is un-impacted. However, time is short in drama, and therefore serendipity: Weed meets Jill Evans, a shared “friend” of Chris Leavitt, and as she accompanies Weed on his road-trip search for his friend, she lets slip the clumsy near-rape Chris had attempted in CFTH. For the determined separatist, Weed, this presents an opportunity for his own suffering to quickly metabolize so that he might support another.
And later, as he finally connects with Jules Grotius, the creator of the subversive online game, ‘The Situation’–the self-styled guru of a new medium through which conscientious activism can be achieved–he listens, half-percolating the needs of his re-emerging self, half-reconciling current events with past traumas, while absorbing the heroic purpose he has unwittingly lived over the previous several days. Weed the drug dealer may live on. Weed the woman-distrusting bully may even persist with old habits. But Weed the game-fixated, insular enigma has been dealt a death blow.