On Whose Authority?

Ann Green, PMHNPHugh Polk, MD
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Welcome to a conversation between two social therapists who meet regularly to share and advance our therapeutic work. We hope these dialogues can support and stimulate others who are integrating developmental conversations into their therapeutic practices and personal growth. See the first post in the series for a brief explanation of what social therapy is and the perspectives we’re coming from in our dialogues.

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Hugh:  I’ve been thinking recently about how some of my clients see me as an authority figure. I think that’s problematic. Even more problematic is that I sometimes relate to myself in that way. As a psychiatrist, I was trained to think of myself as a keeper of truths, a judge of what behaviors, attitudes or reactions are right and wrong, normal and abnormal, good and bad. If I’m not attentive to what I’m doing, I can fall into old habits. I really don’t want to play that role, because it stifles human connectivity and gets in the way of creating a collaborative environment with clients in which they can develop.

Ann: It’s not only psychiatrists who have to beware of falling into becoming the authority figure. I think all therapists learn to play that role, and those of us who don’t want to play it have to continuously “unlearn” that training. What’s making you think about this now? What’s happening in your practice that’s put it on the agenda?

Hugh:  One of my clients, Martin, is the single parent of a teenage daughter. Melanie is a lovely kid, and — like most people, young or old — can occasionally be self-involved, irresponsible, drive-you-crazy exasperating. Over the years, Martin has asked our therapy group for help in raising Melanie. A big part of that work has been exploring with us what sort of father he wants to be, which includes challenging assumptions and expectations — his and others’ — about the role of parent, or, I should say, the role of Parent (with a capital “P”), Parent as authority figure. It’s the work of questioning Martin’s allegiance to that role that’s made me conscious of my own inclination — especially when I’m feeling impatient, or critical, or even just tired — to act the part from the authority of the therapist’s chair. And I don’t like it.

Ann: That’s really interesting. Say more.

Hugh: In a nutshell, Martin thinks that he should be able to get Melanie to do what he wants her to do, like errands or homework, and to stop her from doing what he doesn’t want her to do, like having a boyfriend, because she’s too young. Not surprisingly, Melanie doesn’t agree. When Martin tries to “lay down the law,” as he puts it, Melanie rebels: she challenges his rules, she gets angry, she becomes secretive and distant. It’s terribly painful for both of them when this happens. They’ve been through a lot together over the years and they genuinely love each other. When they’re not fighting, Melanie often tells him that she thinks he’s been a great father. That means a lot to Martin, who’s grown a great deal over the years in learning how to be close to his only child. But he’s very vulnerable to letting his idea of a Parent, with a capital “P,” take over, especially when things aren’t going well.

Ann: Mothers and fathers are under an enormous amount of pressure to get their kids to do things the “right” way — and when their kids don’t, they view themselves and are often viewed by others as failing. If you’re a single parent, the pressure is, if anything, even greater. So it makes sense that parents will often resort to their role as authority figure. But that’s just as likely to breed rebellion as obedience.

Hugh: Last week, Martin came into his therapy group distraught. “The worst” had happened, he said: Melanie was pregnant. Martin told the group that he was furious with her, and with himself. He wondered how he could have let it happen. He began berating himself and Melanie, saying there was something “wrong” with her, and with him. But then, he said, he thought about the many conversations the group has had about parents needing to choose what kind of relationship they want to have with their children, and instead of yelling at Melanie he put his arms around her, told her that he loved her, and that they would figure out together what to do. “It wasn’t easy,” he told us. “But I’m not going to abandon her.”

Ann: Wow! In that moment, he discarded the role he’s supposed to play — the role most people think he should play — and he chose to take a completely different path! That takes a lot of guts, doesn’t it?

Hugh: It does… we were all very moved by what he told us. And it gave me a lot to think about. When Martin first started speaking, I had been gearing up to ask him all the “right” questions: why hadn’t he turned to the group as soon as Melanie told him her news. Why hadn’t he asked for our support right away? What made him think that he should have that difficult conversation with her on his own? These were all the “right” questions for my role of The Therapist. But before I could get going, another member of the group, Arlene, spoke up. “You’re a wonderful Dad, Martin,” she said. “I know how hard you’ve worked over the years here in group to be that sort of father. It took a lot of guts, plus a lot of love, to put aside your anger and let her know that you weren’t going to abandon her.” The group followed Arlene’s lead. And at that point, I realized that The Therapist had nothing worthwhile to say.

Ann:  So by letting Arlene, and the group, choose a different direction from the one you had in mind, you took a different path, too. How wonderful is that?! Authority figures like “The Therapist” are tied to what they already know is true and right and good… therapists (with a small “t”) improvise, creating with whatever their clients bring to the conversation.

Hugh: The problem with authoritarianism is that it shuts down the possibility of ordinary people (that’s all of us) creating anything new.

Ann: Right. There’s not much room for development when authority figures are running the show! I think the question for us therapists is: Will we give up our addiction to knowing (knowing what’s “the right path,” what’s the “smart” answer, what’s the solution to their problems…) in favor of supporting our clients to create new ways of building their lives? It’s a choice that has to be made not just once, but all the time as we work.

26 COMMENTS

  1. Yo, This makes me think about the nights I listened to coast to coast in my bedroom living alone waiting. Laughing at John B when he joined George as a Saturday dj.

    On this blog says this and the other that. Someone says they value something doesn’t mean they actually do.

    With radio program the guy fooled me because I also subscribed to caravan show. Many people were aware of his prejudice because they treated George as somebody they used to know.

    It took me about month and I cancelled after his bombastic speech bombarded discriminatory comments then said he is huge fan of Hendrix.

    I’m staying with George. I think though most of programs are ok, but some of evenings get awesome stuff.

  2. I was not able to read the blog. As a retired LISW and a psychiatric survivor I am put off by one therapist talking with another. This is another co option of psych survivors and other folk’s personal narratives for mental health professionals fame and profit or publishing rights. At least this is how I have come to view the books and ect.
    It’s a sticky wicket and I think we need dialogue.
    The other issue is we psych survivors have no diagnostic label expungement process as our fellow citizens do with legal crime past labels.
    If we could dialogue as in a round table yes.

  3. With all due respect to the authors, I think this is the best example of why so many people feel abused, dehumanized and marginalized by the mental health industry, straight from the mouths of clincians. I can’t detect a grain of truth or light in this piece whatsoever. I find it to be pure self-indulgence and self-aggrandizing, as usual–and this time, squared. This IS the problem. Frustrating.

  4. I read it.
    Feels Icky, in a way I can’t quite put my finger on. I don’t disagree with Alex, but his comment doesn’t quite capture why this piece feels so icky. These authors did a similar conversational-type piece awhile back, and it felt icky too. I wish I was feeling sharp, so I could be eloquent and accurate, but for today, “icky” is the best I can come up with. Maybe others will hit on the right words to describe it; if so, I will echo theirs.

    • My feeling response was the same as yours. For me, absence of truth and light feels icky. This is not only contrived, it’s projecting all sorts of illusions. This is the antithesis of truth, like a black hole. When one is in the sytem, being talked about by clincians is the epitome of unsafe! And all too common.

  5. I read it as well. I think Icky is a good summation.
    I do have a couple of questions:
    How are questions like “Why hadn’t he asked for our support right away?” “What made him think that he should have that difficult conversation with her on his own?” in any way “right” questions to ask of an adult? What sort of group would encourage this sort of dependency?
    If this is not fiction, did “George”, “Arlene” and (especially) “Melanie” all give their consent to be described in this “conversation”?

  6. “On Whose Authority?” Good question, and since we’re discussing DSM “bible” believing therapists, the answer to that question would be on the authority of the DSM? Or would it be based upon the authority given to DSM believers to force “treat” their clients, if they disagree with the DSM believers/therapists?

    But given the lack of scientific validity and reliability of the DSM, is that a valid authority? And when “treatment” requires the government make it legal to force or coerce such “treatment,” doesn’t that somewhat imply that the “treatment” is possibly so bad that no one would voluntarily want it? Which once again begs the question, is that a legitimate authority?

    I do agree, “There’s not much room for development when authority figures are running the show!” And I agree, therapists should end their “addiction to knowing … in favor of supporting our clients to create new ways of building their lives.” Especially since their DSM “bible” was debunked as “invalid” in 2013.

    I think one of the things others find “icky” about this blog is the obvious blame the client nature of therapy. And the intentional disempowering nature of therapy, as implied with the therapists initial thoughts, “why hadn’t he turned to the group as soon as Melanie told him her news. Why hadn’t he asked for our support right away? What made him think that he should have that difficult conversation with her on his own?”

    If “These were all the ‘right’ questions for [your] role of The Therapist,” you were taught wrong. You were taught to disempower and blame your clients, rather than to empower and help them. Kudos to your client for acting on his own, in a loving and accepting manner towards his daughter.

    • This is pretty bad, too.

      “Ann: Wow! In that moment, he discarded the role he’s supposed to play — the role most people think he should play — and he chose to take a completely different path!”

      So these therapists are saying that screaming at, and disavowing one’s child, and future grandchild, is “the role he’s supposed to play — the role most people think he should play?” I don’t agree. And since when did loving one’s child, and future grandchild, become “to take a completely different path?”

      Wake up, therapists, your entire field was taught wrong.

    • Dear Someone Else,

      Thank you for your thoughtful response. I agree that the question of whose authority is being exercised in psychotherapy is a good question. I think that authority is imposed from the top down by “the powers that be.” Power, on the other hand, is created and built from the bottom up by ordinary people creating their lives together. As a psychiatrist and social therapist (see the intro to our first post for a brief statement on social therapy) I am struggling to give up my authoritarian-ness because I believe that creating power with my clients and like-minded colleagues is the only way for us all to develop emotionally and socially. When you point out that “If these were the ‘right’ questions for [your] role of The Therapist,” you were taught wrong,” I agree. I believe that all psychotherapists (and, of course, psychiatrists) are taught wrong in their training–we are taught to be authority figures. If we are going to practice a non-authoritarian therapy which empowers our clients, we are going to have to transform ourselves to become co-creators with our clients of their and our emotionality. And we have to support their struggle to break free of their allegiance to their authoritarian-ness as well.

      • I agree, Hugh, the “powers that be” are the problem. How ironic, that’s what “mental health” workers misdiagnosed and drugged me up for knowing in 2001. Now you all are finally awakening to this reality, too. Hurrah!

        I agree, “all psychotherapists (and, of course, psychiatrists) are taught wrong….” However, personally I think it might be easier to properly train logical people who already know how to actually help people, than to try to retrain all the miseducated psychologists and psychiatrists.

        The bottom line is, however, we’ve had the wrong people in charge for way too long now. Some day “Rockefeller medicine” will be seen for what is actually is, a complete disaster. Although we have systemic problems in many industries. As Chris Hedges said:

        “We now live in a nation where doctors destroy health, lawyers destroy justice, universities destroy knowledge, governments destroy freedom, the press destroys information, religion destroys morals, and our banks destroy the economy.”

        • Dear Someone Else,

          thanks for your response. I agree “we’ve had the wrong people in charge for way too long now.” We need a whole new psychology, based not on labeling people but bringing people together to collectively recreate our emotional lives going forward. The institutions of psychology and psychiatry are not going to do it–they’re too invested in the status quo. It’s going to have to be grassroots, from-the-bottom-up work done by ordinary people and progressive, open-to-change practitioners of all stripes working together. This website is part of that work.

          • “The institutions of psychology and psychiatry are not going to do it–they’re too invested in the status quo.” I agree, I’ve had very little success in changing minds, even when I point out my medical research findings regarding the fact that the antipsychotics create “psychosis,” via anticholinergic toxidrome. None of the doctors can argue with that reality, when pointed out. But “it’s too profitable” to stop defaming and drugging the children, according to one pediatrician with whom I spoke. It’s shameful.

            Although I did have an art show which displayed psychiatry’s crimes against their patients in a very poignant manner, given the reality that “a picture paints a thousand words,” thus a portfolio of works tells a compelling, and to some, disturbing story. A show which was “too truthful” for the guilty parties, thus quite controversial.

            Ironically, my psychiatrist saw most of the paintings years earlier, called them “insightful,” and weaned me off the drugs. But when the truth is attached to my paintings, oh! my artwork becomes “too truthful” and “prophetic.”

            I hope you’re right this website will help change the bad systems. Personally, I hope both the psychologists and psychiatrists will get out of the child abuse covering up and child abusing business, since their continuing mass murder of innocents is breaking my heart. But I must confess, heartbreak is great inspiration for art.

        • SomeoneElse, I had not heard of Chris Hedges, so thanks for the quote. Wow, it is so true – yet we are supposed to walk around like happy robots who drank the Kool-Aid of the powerful, and remain totally oblivious to all the corruption and injustices that are engulfing us and destroying lives.

      • you said:
        “If we are going to practice a non-authoritarian therapy which empowers our clients, we are going to have to transform ourselves to become co-creators with our clients…”

        I do not believe that someone can shed the habit of authority while simultaneously wielding its power. It is your default position, and will be unless it is unavailable to you. If you really and truly wanted to place yourself on an even level with those you purport to “serve” or “help” you’d give up your license and do your listening and “helping” as a true peer, and discard the safe comfy cloak of authority. Not jusy you, Hugh, but all the “helpers” who make these claims.

  7. Yeah well I’m thinking this is not very cool and I ran away crying hurt feelings.

    There are some traces having hole to keep falling in time and again. That mantra was important with me growing up and having intimate relationships. I mean that mantra or mindsets gets me. Even today gets me. It’s cool.

  8. A second comment and I’m gonna hunker down there. I’m Hunkering. It’s very important and an automatic or instinct reaction, because I basically care about this. It’s a value.

    If I’m into a construct or theme of peer support and therapy basically it’s cool I don’t be upfront and say it. I just enjoy how it’s going. There’s a potential someday to join a talk group or not.

  9. I have proposed an Anti-BioPolitics Movement, which opposes Psychiatry, Psychotherapy, and the Recovery Movement.

    It is broader than Anti-Psychiatry ever was, because the situation is more serious. We have a huge segment of the population which lives as an underclass, regulated by Psychiatry, Psychotherapy, and the Recovery Movement.

    Most of all, get the drugs off of the market, and stop the gov’t licensing and support.

      • Why would someone be against a Psychiatrist doing talk therapy, but not against a Psychotherapist doing the same thing?

        And if we are neutral on Psychotherapy, or even appear to encourage that and Recovery Programs, then doesn’t that just reinforce the public view that sometimes Psychiatry, Drugs, and even Coercion, are necessary?

        Looking at Marx, Fanon, and Foucault, and trying to learn all that I can, its about the creation and the management of an underclass. Where I live, this is vast and pervasive.

        We can talk here, as it allows PM’s
        https://openingoftheway.createaforum.com/

  10. This reminds me of the (patient / authority figure) conversation when it comes to med compliance. Year after year it’s the shrink that convinces you it’s the best option for you (with warnings of dire consequences if you ever stop). You become more and more ill and more and more dependent on the medication. Sad.

  11. Human Psyche should have authority, but psyche is illegal. Because we have illusions of spirituality in the place of psychology. That is why we should all read James Hillman. Because he have noticed it.
    Without psychopathology life would be an illusion. Without illnesses, our health means nothing.

  12. I had a different impression from this blog. Hugh and Ann were honest in acknowledging they were trained to be authoritarians and had followed that approach when trying to help people. I viewed this blog with positivity because Hugh and Ann realized and admitted this approach was not helpful and was disempowering to people. My take away is they want to discard the old approach and take a much different approach in order to empower people. I say kudos to acknowledging and wanting to make changes. Now if only all psychiatrists and therapists could be so honest.

    • Thank you, Rosalee, for your comment. Ann and I are social therapists (see the intro to our first blog for a brief description of social therapy) and have been working for 40 years to create a non-diagnostic, performance-based, group therapy approach to helping people with their emotional difficulties. Central to it is group members creating the group as a non-judgmental, non-authoritarian activity of creating our mental health collectively. Fortunately, there are other therapists who are also challenging the authoritarian-ness of psychology and psychiatry. There is a post-modern movement of social constructionists, narrative therapists, open dialogue practitioners, critical psychologists and more who are building new approaches with their clients. If you know of psychiatrists and therapists who want to join this conversation, please let them know about it.

      • Hugh since finding MIA I have told every professional I have spoken to (family doctor, psychologists, the CMHA and an honest, open-minded psychiatrist) about the MIA website and gave them the link. I already have their support and validation on the matters I am dealing with and know they would find the information interesting and relevant. I looked at the website for the East Side Institute. It is most interesting and inspiring and I will pass this information on as well to any that are interested. (Fyi, the link does not work so had to do a google search)

  13. And Ann where is your voice here?
    This thread is symbolic of one of the many issues we all as a world are dealing with.
    In the light of all of the blogs of abuse and medical malpractice there still is no professional voice of apology. And there’s the rub isn’t it? In our litegeous society this could prove problematic but since Hugh and Ann are in their senior years maybe not so much?
    When they were young there was Heinz Kohut a WWII refugee who came to the states and developed Self Psychology – the best to come out was therapy as bike riding. It was quickly quashed.
    The onus of working with insurance companies and yes I did as well is still part and parcel of the dialogue that has not been addressed. Adult Adjustment Disorder but they would only make payments for 10 visits or so and thus up the annuity to a different label with more payments.
    The other route to go was private pay but two issues – elitist and what about abuse and neglect issues? Very dicey!
    And what about Social Justice?
    Again white therapists talking about what seems fairly well off clients.
    If you are both going to own nonauthartarianism then be real and honest and take full responsibility.
    And where are the comments from Ann and Hugh and others on the psych survivors’s blogs?
    Again rampant discrimination.
    There is nothing wrong with admitting error or mistakes from either ignorance or really bad idea.
    Mistakes are how humans learn.
    Unfortunately, we have lost the ability to truth for the base needs of greed and profit. And we all are paying the price.