Should A Psychiatrist Testify About A Patient’s Ethics?
Posted by Dr. Vollmer on November 7, 2013
Stephen Glass lied, went into psychoanalysis, went to law school, passed the bar, and now is not allowed to practice law because of his history of unethical behavior. According to the above article, his psychiatrist testified on his behalf, causing me to pause. As a psychiatrist/therapist, I could not verify the ethical behavior of my patients, as I only know what is presented to me in my office. I am having trouble imagining how I could weigh in on whether a patient of mine could or could not work in a particular field, as there is too much uncertainty, given the limitations of my contact, and the limitations of my understanding of the criteria for employment. I could weigh in on his state of mind, with his permission, but to say that his ethics have undergone a major transformation, to me, seems like a large leap, and possibly a wish, on the part of the psychoanalyst. The analyst wants to believe that his work is curative, and, as such, previous “bad behavior” transforms to a positive life force, where patients learn to respect the rules, as they develop new-found respect for themselves. This, sometimes happens, but other times, is an analyst’s fantasy. The patient that has affairs, does not necessarily cease this behavior, because he understands what unconscious motivation drove him to betrayal. Understanding and changing behavior are sometimes related, but not consistently or reliably. I think it is dangerous to say that because a patient comes four times a week, “we really understand him,” as if we can not be fooled into seeing what we want to see. Of course, we can, and are, and it is this understanding that makes us do good work, because humility is part of the therapeutic action. Understanding our limitations strengthens our work. Taking assumptions outside our office threatens to weaken our value as psychoanalysts. We help people understand themselves better, and then we hope for the best, like any parent who raises a child. Ultimately, the patient makes decisions for themselves, and we care that they behave in a way which both helps society and themselves. Caring, though, is different than knowing.