Friday, February 22, 2008

Negligence or Stupidity?

I recently attended a seminar on risk management. The presenter works for a company that insures psychologists. He told us many things that were obvious, some of which was useful. Like the fact that most psychologists get themselves into trouble for one of two reasons – negligence or stupidity.

Negligence included not providing appropriate care, such as withholding a client’s information because he or she owes you money. Stupidity included sleeping with clients. Or terminating with clients and then sleeping with them—as if termination was ever a protection against this particular brand of stupidity.

OK, so I get that I can reduce a modicum of risk by keeping my panties on. By avoiding dual role relationships – you know, by not offering psychotherapy to my dentist. And by not using forms of treatment for which there is no empirical basis – such as past-life therapy and hypnotic regression.

All of the emphasis in this seminar was on what I could do to avoid having my clients turn around and sue me. I understand this definition of risk. And since I already wasn’t doing any of the things I should not be doing, the good news is that I have nothing to change.

But how do I avoid getting chopped up with a meat cleaver like Kathryn Faughey?

Since her death, I have found myself wondering what Faughey might have done that could be categorized as either stupid or negligent. And it irks me to even ask this question because implicit within it is a blaming of the victim, which hardly seems just.

Nothing in this seminar told me how to reduce the risks associated with attempting to treat the murderously angry. Notice that I have not assumed Faughey’s killer to be insane, only that he was enraged. And that he was enraged specifically at Faughey. He seemed to want her destroyed. The attack seemed bizarrely personal. If it wasn’t, the poor client who was sitting in the waiting room, and the 70-something year old man who rushed to Faughey’s defense would also both be dead.

I also initially assumed that the killer was a client of Faughey’s. Others thought so too, which is why the courts were going through the laborious process of finding ways to violate her clients’ confidentiality in order to get to that elusive one. Faughey’s manner of death contained a grotesque quality of intimacy that could only be associated with a husband, lover, or a therapy client.

The therapy relationship is a truly intimate one, involving layers of trust and sharing, and promises of inviolability. But the promises are one-sided. Therapists do their part to take care of and protect their patients. And in doing so, they sometimes expose themselves to risks for which a seminar has yet been invented.

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