Therepeutic Civil Disobedience‏

[sophia-sadek.livejournal.com]

Happy Labour Day, cats and kittens!

A number of years ago I was working with a group of homeless women and men. One of the members of the group, Jake, came in and boasted about killing a guy. Jake was a white supremacist migrant from Oregon who turned tricks and shot up crank. He had not actually killed anyone, but he did send the guy to the hospital. They had gotten into an altercation on a bus when Jake stabbed the guy. Jake's buddies counseled him to keep his antics to himself lest someone call the cops. His story showed up in the news the following day.

When I later retold the tale to a friend she was appalled that I did not turn Jake in myself. She thought it would to him good to cool his jets behind bars. I disagreed with her assessment. Behind bars he would spend his time with a bunch of like-minded white supremacists learning how to become a more hardened crook. In the wider world he would have a greater variety of people and experiences from which to learn and grow.

This case came to mind when I listened to Toby Watson describe his practice in Sheboygan, Wisconsin. In a podcast interview he advocates a form of civil disobedience against mandated reporting laws for psychotherapists. He describes a few cases where he acted counter to the requirement for licensed therapists to call the cops when a client describes violent tendencies. In making his stand public he makes himself vulnerable to bullying by the bad boyz. It is tantamount to posting dissident theses on a church door.

Watson makes some pretty good points in the interview. His goal is to benefit his clients by getting them to take more responsibility for their actions. He sees the medicalization of violent conduct as an approach that tends to prevent perpetrators from moving beyond institutional dependency. His approach to deinstitutionalization seems to have some merit. I only hope he is not derailed by the big guns who risk the loss of funding were his work to become popular.

What is your perspective on mandated reporting laws with respect to psychotherapy? Are they important for public safety? Or are they a manifestation of totalitarianism to be resisted by conscientious professionals?

Comments

[notmrgarrison.livejournal.com]

In the wider world he would have a greater variety of people and experiences from which to learn and grow and stab.

Fixed.

[sophia-sadek.livejournal.com]

He had a habit of stabbing people who pushed him around. There is not a lot of variety there.

[paft.livejournal.com]

ss: He had a habit of stabbing people who pushed him around.

Oh so we DEFINITELY want him out on the streets.

[devil-ad-vocate.livejournal.com]

Criminals are experts at using rehab efforts to their own advantage - many consider it vacation time from lockup.

[sophia-sadek.livejournal.com]

Jake was quite skilled at gaming the system. He sold his methadone allotment to raise money to buy crank.

[fornikate.livejournal.com]

sounds like a stand-up guy who really takes responsibility for his actions

did you invite him to move in

[dwer.livejournal.com]

at what point do your red-flags go off? Do you HAVE red flags?

Hypothetical Situation

[muscadinegirl.livejournal.com]

My only problem with this is: what if the psychiatrist's evaluation is wrong and they report a person who is not, in fact, violent? It seems a huge price to pay for human error.

[sophia-sadek.livejournal.com]

Watson is more concerned with getting people out of the psychiatric mill. That is one of his motivations for not reporting a client who threatens violence.

[paft.livejournal.com]

And anyone who gets attacked, maimed, scarred or killed by one of those patients is just collateral damage, right?

[underlankers.livejournal.com]

What does this have to do with totalitarianism again? Why is examining criminals to see if they might be mentally ill a bad thing?

[sophia-sadek.livejournal.com]

The totalitarian aspect is the way that health care professionals are required to serve as law enforcement officers. I have no idea where you got the idea that this topic has anything to do with examining criminals for mental illness.

[gunslnger.livejournal.com]

I dislike zero-tolerance laws, and mandated reporting is just another one of those. People need to be able to assess the situation and devise an appropriate response that fits rather than be driven by a static model handed down from above which often doesn't fit the particulars.

[sophia-sadek.livejournal.com]

It is good that there is something we can agree on.

[gunslnger.livejournal.com]

I likely would have informed the police though.

[yes-justice.livejournal.com]

Until he reckons with his violent nature, it will continue. That, you can take to the bank. Seen it play out too often to believe anything else.

Some men do that in jail. A type of rock bottom.

While I loathe to call "authorities" I would be haunted by the fact that he could hurt or kill someone else (or more likely someone will hurt or kill him) when I could have done something to prevent it.

I probably would not associate with that person much after though, unless it was a very close friend.

Speed: red flag
Turning tricks: red flag
Stabbing: red flag

All together, and bragging about it, end of game, I'm outa here.

[sophia-sadek.livejournal.com]

I would recommend that you avoid a profession that entails interaction with homeless people.

[paft.livejournal.com]

So how many people would he have to stab before you felt compelled to summon the authorities?

[yes-justice.livejournal.com]

I have, though I do volunteer for StP. I just know my limits. Its been my experience that I tend to lower my behavior when I hang out with those sorts of scenes. Some people can handle it, I succumb. So, knowing my limits is important to keeping myself outside prison and out of trouble. I wasn't always so discerning, and had my own run ins with with law and homelessness enough to know I have limits. I guess its a cop out, but some of that shit freaks me out.

[meus-ovatio.livejournal.com]

I think people who are made aware of rape and murder become accomplices.

[sophia-sadek.livejournal.com]

That is a happy thought. It must be one of those side effects I hear so much about.

[harry-beast.livejournal.com]

Perpetrators moving beyond institutional dependency is all well and good, but maybe we could give some consideration to helping the victims of this kind of violent offender move beyond being stabbed.

What is your perspective on mandated reporting laws with respect to psychotherapy?
I think that all citizens have a responsibility to do to their bit for public safety. People should report crimes and they should report activities or information that they reasonably believe to be credible indicators of an imminent crime. A therapist has an obligation to notify authorities if in his or her professional judgment, a person is a danger to others.

Are they important for public safety?
Yes. Preventing violence is a public safety issue.

Or are they a manifestation of totalitarianism to be resisted by conscientious professionals?
Should doctors ignore threats to public health? Should engineers turn a blind eye to structural defects in safety critical infrastructure? No! Professionals should serve the public, not their pet political viewpoints, and that includes protecting the safety of the public.

[sophia-sadek.livejournal.com]

I agree that the victims need help, too. The guy who wound up in the hospital also had a psychiatric label.

As for mandated reporting, you might want to listen to the interview podcast. Toby Watson has some compelling arguments for how civil disobedience can benefit a person in need. The structural safety issue here is in the structure of how health care is administered. There are flaws in the system that people like Toby Watson seek to ameliorate.

[kayjayuu.livejournal.com]

What's the definition of "accessory after the fact"?

[sophia-sadek.livejournal.com]

I am not a lawyer, so I cannot answer that question.