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Ethical Boundary Considerations and Repressed Memories of Sexual Abuse
On the last track, we examined the various sides of the controversy regarding repressed.
On this track, we will discuss cognitive dissonance created in the therapist when predisposed ideas are challenged and eight key characteristics that red-flag your co-dependent clients to be predisposed to therapist implantation of ideas of sexual abuse.
Ethics - The Introduction of Cognitive Dissonance
If one opinion advocate, as Festinger states, is "seen as an expert or very knowledgeable about such matters, the dissonance between knowledge of his contrary opinion and one's own opinions will be greater." I am sure you probably have observed this in your therapy sessions with your client. Festinger adds, "the person will actively avoid situations and information which would likely increase the dissonance."
In therapy, this may result in the client cutting him or herself off from friends and family that express any doubts. By maintaining a very close-minded approach, the client isolates themselves in a reality that might be false and unhealthy for their growth.
Ethics - Therapist Predisposition
In reality, the subjects were students and other ordinary healthy volunteers from the community. As soon as they were admitted, they totally ceased simulating any symptoms of schizophrenia whatsoever. However, Rosenhan noted, "The pseudo-patient spoke to patients and staff as he might ordinarily speak. However, because there is commonly little to do on a psychiatric ward, he attempted to engage others in conversation. When asked by staff how he was feeling, he indicated that he was fine."
The student and volunteer subjects wrote down their observations of the therapists and patients. Amazingly, in each case it was only the other patients in the hospital that detected the pseudo-patients and not the staff. The other patients would make statements like, "You're not crazy. You're a journalist or a professor. You're checking up on the hospital."
The real patients, just by normal, everyday observation, could see without any pre-accepted theory that the subjects were perfectly healthy. However, those psychiatrists, even though they kept close observation of subject's behavior, could not see that they were devoid of mental defect.
Regarding sexually abused clients, once the therapist is predisposed to the idea of sexual abuse, perhaps by a wife seeking custody, the therapist may tend to pursue the line of thought regarding sexual abuse, just as the therapists on the in-patient unit were predisposed to see the healthy subject as being schizophrenic because of their admission criteria.
Ethical Minute of Contemplation
Sophia, age 47, suggested to her therapist of three months that she believed she might have been abused as a young girl and had repressed the memories. When asked how she had come by this realization, she stated, "Well, I saw this episode of Oprah where all these women had repressed the memory of their childhood abuse. They described the symptoms they'd had before their discovery, and, oh my god, it was exactly what I was going through!"
Her therapist was skeptical, because the symptoms Sophia described were not the ones she had been exhibiting months before. Before treating Sophia, her therapist had compiled a 8 point checklist of examples of a client that is over-eager to find a cure for their behaviors and therefore jump at any influence, for example, alleged child abuse.
8 Point Checklist
-- 1. Try to please others instead of themselves,
Such descriptions fit Sophia, and her therapist soon realized that any kind of diagnostic implication from him would unduly influence Sophia into trying to fit into her symptoms to the disorder. As a result, the therapist focused the sessions on Sophia with little input from himself.
On this track, we discussed predisposing the therapist and a codependent checklist.
On the next track, we will examine the influence of New Age Mentality on repressed memories of possible sexual abuse as it relates to intuition, imagination, and hearsay.
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