Tag Archives: confidentiality issues and psychotherapy

The old scripts of Daniel Pierce

 

“We met on consecutive days, Aaron and me. I detailed events, spilling out everything I could think of, remember, while he filtered the present through the past. Did I mention that my mom left my dad when I was thirteen because she found out he wasn’t a prairie vole? Didn’t I? Well, Aaron did. He does that: remembers things like a bucket sat beneath my mind”

—a passage from Venus Looks Down On A Prairie Vole, about an exchange between a protagonist and his confidante therapist.

Self identities—strategies of being in relationship—are often fixed and rigid. Quantum phenomena collapses time.

Daniel Pierce is a psychologist burdened by a question of ethics. A man in his practice—a man whom Pierce has seen once in a professional capacity—has possibly committed a horrible crime against a child. Or, the man is the subject of a cynical fabrication designed to leverage a judgment in a custody battle. Through serendipity, Pierce re-connects with this man, though not in the course of his day-to-day work, but rather, ironically, in the midst of his own troubles. They meet in a halfway house, as peers in addiction and mental illness, and through that meeting, Pierce hears a fuller yet still uncertain story.

In being a listener, a helper, Pierce filters what he hears though his own prejudices and back-story, as we all do. Along the way, he is influenced by a reformed prostitute, and now strident advocate of abused women and children. What is Daniel Pierce’s old script? He was a lonely kid, separated by strangeness, a habit of talking, sometimes singing to himself. Today he might have been diagnosed with ADHD, or tagged as being on the continuum of autistic disorders. His mother, now languishing with Alzheimer’s, once doted upon Daniel, admiring his childlike charm, the ‘twinkle’ in his eye that few others saw. She perhaps coddled him. Daniel’s present-day forgetfulness is half an organic condition suggestive of alcoholism, and half an implicit bond with this now absent figure.

Daniel’s father manifests the Oedipal failure: a man disgraced by his infidelities, he epitomizes the fallen, weak male reviled by the likes of Lira, Daniel’s antagonist and misandrist pursuer. Daniel had stayed closer to his now late father over time—physically, at least. Though his father’s caretaker in his final years, Daniel had always been different: most notably, a monogamist to his recently deceased wife, another doting figure. Unlike his father, he is a Prairie Vole: respectfully distant from other women. Still, his aloneness is a cost, leading him to practice dubious boundaries, as a therapist and as a storyteller. His crossing-the-fourth-wall sidebars (an example above), are intended to convey his isolation, his need to be understood. The story of Venus is based loosely on real events concerning child abuse, the knotty issue of child custody warfare; of mandated reporting requirements for psychotherapists; of confidentiality. Try to understand. Before you need someone someday to listen before blowing whistles, try to understand.

 

Graeme Daniels, MFT

 

 

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Another three minutes with the CAMFT board

Graeme Daniels, MFT

These CAMFT board meetings: they happen three or four times a year, in hotel conference rooms up and down the state, always on a Saturday. The board of the California Association of Marriage and Family Therapists consists of a dozen members, men and women who don’t talk like therapists, but rather business people or lawyers. They don’t even seem to think like therapists, but for three minutes at a time at the outset of these all day gatherings, they promise to listen to therapists.

Being listened to is not something I expect, necessarily. Recently, it’s been hard going, getting others to take things in. There are clients as well as certain others who don’t return calls. Publishers and agents who won’t respond to e-mails. Even Pete Townshend, who asked to meet me after my Tommy paper got published, didn’t have much to say and walked off before I could start a conversation. Why? I wonder. Why am I so drawn to unavailable men? Anyway, at eight-thirty on a Saturday morning, my friend Ben and I showed up at a San Francisco hotel ready to be listened to, about AB1775, that stupid child porn law I’ve been blogging about, and—from Ben, mostly—the problem of insurance companies not paying claims. That’s actually far more serious, I later thought after hearing him speak.

At eight thirty we were ready to take part in one of these ‘members forum’ segments of a board meeting. They are supposed to last thirty minutes and proceed on a first come first serve basis. Wading through a vestibule, entering the room allocated for the proceeding, Ben and I found ourselves alone, gazing at an array of chairs circling a large table. Moments later, board members sauntered in, chatting, carrying cups of coffee, schmoozing. They looked at us and acted surprised, as they’d not been told there would be ‘observers’ this time around. A woman I recognized named Cathy Atkins, who also recognized me, took a quick look my way but then glanced off, choosing to admonish Ben: “in future, perhaps you could write us an e-mail, let us know you’re coming.” Weird, I thought. Last time I came to this thing there were about a dozen ‘observers’, all ready to speak—no RSVP seemed necessary. I once saw a video of one of these meetings in which the room was filled with over fifty members, also lining up to speak. And by speak I really mean protest. Something’s changed, I realized. The spirit of dissent in this organization has, shall we say, diminished?

After a call-to-order and reading of agendas, a woman in charge announced it was time for our members’ forum to begin. Slightly disorganized, she asked who had the timer for the three minute segments. Then, looking down at the forum sign-in sheet, which contained only two names (Ben and I), she looked over and beckoned me to speak, pronouncing my name correctly, which rarely happens on a first reading. I’d have been impressed but for the sight of the woman next to her, whispering her knowledge of who I was, which was both gratifying and not. The three women at the head of the table were the new president of the board, plus two lawyers. The femicratic air was balanced by four or five men, most of whom sat at the other end of the table, looking detached, if thinly adversarial.

I began speaking through the anticipated personal blocks: the dry parch in my throat, which can drain the life from my hard syllables; the halting pass at stretched vowel sounds—a more common nemesis of mine. Then there were the externals to contend with: the expressions of a dozen people, most of whom gave effortful looks of interest; some bothered to twist their necks around to face me. There were one or two earnest faces, and even a faint nod from a former president—warmly supportive, if relieved to no longer be in charge. So, here’s what I said.

CAMFT MTG. ON 9/24

1.)      A year ago I was at this meeting in Santa Clara protesting 3 things: the passage of bill AB1775, which now mandates therapists to report ‘downloading’, ‘streaming’, or ‘viewing’ material depicting sexual conduct of minors;

2nd: CAMFT or CAMFT attorneys’ role in not only endorsing the bill, but writing it.

3rd: CAMFT’s misrepresentation of several aspects of AB1775 to the CAMFT membership

2.)      Yet it was clear to me after listening to a later ¾ hour discussion by this board that several members were like many therapists I’ve spoken to: they had not fully understood the implications of this bill at the time of its writing. They regretted their support.

3.)      Others appeared to support the bill, but with dubious arguments: that offenders should be reported to authorities, and by implication persecuted, not treated because “sex offender treatment is not effective”. This is an unfair and reductionist view. Another member, unwittingly paraphrasing the US attorney general, suggested that viewers of underage porn enable its production and are AWARE of the exploitation entailed in child porn. Interesting–not to mention one of our society’s staggering hypocrisies. So if we were aware of the child poverty, the exploitative labor conditions around the world ‘enabled’ by our innumerable consumer choices, would we be culpable…reportable? This insipid bill was written for facile people who concern themselves with exploitation, but only as it pertains to sex.

4.) But finally, for the future: member Mark Perlmutter argued that CAMFT should take a second look, as in scrutinize AB1775 in 2017, with a task force that CAMFT members might be invited to join. Well, 2017 is three months away. My requests to be a part of a task force have been ignored or deflected. I cannot get straight answers from CFS officials as to whether abuse reports have increased because of the new law. Well, they’ve gotten none from me, I’m proud to say. And the director of the SJPD internet crimes against children task force does not return my calls. Perhaps he doesn’t talk to therapists. Perhaps, like some lawyers and legislators, he’s got better things to do.

Graeme Daniels, MFT

 

 

 

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Names matter, don’t matter

 

They do if you give them up. Daniel Pierce is a seasoned psychologist, presumably trained to maintain the confidentiality of his patients, or clients as he sometimes calls them. It’s the most important thing he does, he says, and he doesn’t do much. He gives the reader his name, plus that of some others, people who don’t require or deserve the privacy, but otherwise names are a problem. People’s names, place names: they don’t matter, or they are anonymous. My novel, Venus Looks Down On A Prairie Vole, places confidentiality at the center of a host of themes underpinning its plot: that of a jaded counselor taking an impromptu hiatus from his practice, but thwarted in that effort by a stalking ex-prostitute who wants information about a patient whom she says has sexually abused a child. BTW: this ‘thwarting’ was a main reason the novel was originally called Blocked. The blockages are all around: her blocking of his escapism; his blocking of her social intervention; the internal blocks that Daniel Pierce suffers from, that…well, maybe you get the idea.

Daniel is reluctant to give it up, this information she seeks, but he strings the woman along, hopeful of a diversion to juice up his drunken life; or perhaps he’s intrigued by a strange opportunity. See, he’s met numerous people over time who are similar to Lira, the seductress who takes him to a bar, then to her home, and then upon a ride-along through an alternative world-view, that of an activist. Like many unctuous members of society, she wants Daniel to violate his neutral position, the trust that one of his patients has placed in him, in the service of protecting society, and specifically children. But it doesn’t work like that, Daniel rebukes. In fact, he declares that such cavalier heroics will do more harm than good, impinging upon efforts to prevent child abuse rather than the reverse. He articulates, of course, something I believe: that if our profession is going to help understand child abuse, we have to give its perpetrators reason to speak to professionals. And I mean speak to us, not comply with us. That means maintaining privacy when hearing that which turns the stomach. As far as authorities are concerned, it means not naming names.

Daniel Pierce wasn’t always so inclined to protect devils in order to further understand them. One of his background jobs was that of a group home director—a man in charge of delinquent boys, who keep secrets as well as any therapist, and punish violations of confidentiality more severely than the board of behavioral sciences ever does. A passage depicting efforts to out the identity of a house assailant reveals Daniel as a kind of one-time policeman: a house heavy and dad, lecturing young criminal minds about the importance of standing by the innocent; about not protecting wrongdoers, by giving up their names to those in charge. Daniel’s youthful adversaries managed to disillusion him, by reminding that for many, loyalty is more important than justice; that protecting friends and other loved ones is more compelling than doing right. Now it’s sometime later and Daniel Pierce is not so sure about who is innocent and who isn’t; about who are the abusers, or the oppressed. This is partly because he feels like one of the oppressed, which is hardly surprising, topically speaking. His political leanings unclear, he could be a supporter of either Donald Trump or Bernie Sanders: marginalized, confused, and looking to blame either a subset of society or its entrenched institutions for the messy world he’s a tiny part of.

On balance, his biases are progressive, but above all he’s isolated, seeing hypocrisy, shallow rhetoric and contrived solutions on all sides of the grand social split. He’s alienated, fed up, and tired of social advocates in particular: bleating feminists on the left, blow-hard paternalists on the right. Grieving the loss of his one and only love of his life, and estranged from his son, his only child, he’s in collapse, sliding along a path towards a bottom out drinking experience until this one woman appears, like a seraphic breeze with a provocative mission. She says Derek Metcalf, Daniel’s patient, has committed a horrible crime, and that Daniel can and should help him to confess, if not report that event if it’s already occurred. Daniel is non-committal, neither agreeing nor disagreeing with Lira’s plan, or its premise, and privately holding that he doesn’t know much. Like many troubled drinkers, he doesn’t remember much. Actually, he doesn’t even remember (partly due to his alcoholism) ever seeing a patient named Derek Metcalf. The profile Lira gives him sounds a bit like a man named Andrew, who came to see him once, flitting in on a bicycle, discussing a sordid life of street drugs and prostitutes, appearing and later proving elusive, for he too is on the run, escaping from his life, operating incommunicado, living anonymously, having sex anonymously; explaining that his name, where he’s from, where and who he is at any time doesn’t matter. Only it matters.

 

 

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