 HEN
I conduct psychotherapy, I do not accept
managed care, and so I always assume that clients
paying me out of their own pockets really want help and therefore are not
deliberately lying to me. Psychotherapy, after all, depends on
honesty.
Nevertheless, people do lie, for a variety of
reasons—shame,
guilt, fear, etc.—and
the lies have to be dealt with as therapeutic issues. In such cases, clients
essentially pay me for the privilege of
resisting treatment.
But everything
changes if a person
• |
commits a crime
and then wants to make a legal defense based on his or her mental
condition; |
• |
is ordered by
the judicial system to be psychologically evaluated,
tested,
or
diagnosed; |
• |
is ordered by
the judicial system to receive
psychotherapy; |
• |
sues someone
on the grounds of psychological damages. |
In cases such
as these, there are strong motives for deception which can cast the shadow
of doubt on everything that is said in psychotherapy. Here are some points
to consider.
Insanity
Pleading “not
guilty due to a mental condition” is known as an insanity defense.
Insanity
is a legal term, not a psychiatric term, and so it doesn’t imply anything
about the nature of the underlying disorder. Just about any major psychiatric
disorder—a psychotic disorder (e.g., schizophrenia), a mood disorder
(e.g., major depression), an anxiety disorder (e.g., PTSD), or a dissociative
disorder (e.g., DID)—could be used as the basis for an insanity
defense.
|
In years
past, drunk drivers who caused motor vehicle crashes used to argue that they
were not responsible for their behavior because they were under the influence
of alcohol. But eventually the legal system saw through the foolishness of
this argument. If a person drinks willingly, and gets into a car willingly,
then the resulting crash is not an “accident,” it’s the final
event in a long string of intentional
behaviors.[1]
Therefore, just as the “under the influence of alcohol” excuse
was abused in the past, the insanity defense is often abused today as a way
to “wiggle out” of personal responsibility for one’s
behavior.
In its most charitable purpose, the insanity defense should simply be a way
to recognize when a person’s judgment is impaired by psychological factors
beyond his or her personal intention. In such a case, the person can be sent
to mandated mental health treatment, rather than to prison.
Now, in a perfect world, a person found not guilty by reason of insanity
would, in receiving mental health treatment, gain insight into his or her
unconscious motivation, feel profound
sorrow for the injurious behavior, and could then implore
forgiveness from those he or she injured.
Unfortunately, we don’t live in a perfect world; we live in a world
filled with social fraud and
illusion. And that’s why a web page such
as this must find its place on a psychology website. |
|
Faking
Let’s be
direct: some people will go to any lengths to avoid responsibility—and
punishment—for their behavior. Some people will also do just about anything
to get rich quickly. Whenever a crime has been committed, or compensation
is sought for psychological damages, a clinician would be a total fool not
to consider the possibility that a mental disorder could be outright
fakery—clinically known as malingering.
Exaggeration
and Lying
Even in cases
involving genuine mental disorders, things may not be as simple as they seem
on the surface.
• |
Symptoms
can be consciously
exaggerated
in order to get extra attention, special privileges, monetary compensation,
or sympathy. |
• |
Just because
a person has a mental disorder doesn’t mean that he or she is always
telling the truth. This can really complicate things, even to the point of
making it seem that the entire disorder is faked. For example, a person may
have a genuine case of Dissociative Identity Disorder (DID), also known as
multiple
personalities, but if one of the personalities
lies about just one aspect of the case, it might
arouse enough suspicion that all the other facts about the case lose
credibility. |
Complications
to Psychotherapy
If a person who
has been victimized attempts to find healing through psychotherapy while
litigation is still in process, there will always be some
part of the person that
unconsciously
desires to remain disabled in order to “prove” the legal case.
For this reason, true psychotherapy will be hindered, if not impossible.
Vengeance may feel satisfying, but real psychological healing can happen
only if the person gives up the pride
of victim anger.
What is
“Truth” Anyway?
With so much
of our lives influenced by unconscious
motivation, it can be nearly impossible to determine just why a person did
anything. Whatever conscious reason a person gives for his or her actions,
a dozen unconscious reasons could be in the background. So who’s to
say what is the legal “truth”?
Considering all
this, it can be said psychologically that no matter how much we try to
tell the truth, we are always lying. Granted, the lies may not be deliberate,
but, in all that is said, there is always something left unsaid. And there
is always some motive left unspoken.
In fact, as long
as anyone has something to gain there is reason for deception. Is the DA
prosecuting a vicious criminal, or is he simply looking for a conviction
to add to his record? Is the assistant DA prosecuting a rapist, or is she
trying to get revenge on her father for having sexually abused her as a child?
Is the defense attorney representing an innocent client, or is he more concerned
about buying a yacht with his fee? Is the police officer giving an accurate
account of her struggle with the accused, or is she distorting events in
light of fights she has had with her husband?
In effect, the
legal presentation of evidence amounts to nothing more than a person
showing the court what he or she wants the court to see. And
so innocence, if it is to be discovered at all, can be found only in that
place where there is nothing to gain. Which, by the way, is also the place
of humility. And love.
And yet, our
entire legal system in the US functions on the concept of discovering the
“truth.” Think about that.
The lesson
to be learned here is this:
If someone has anything to gain from diagnosis or treatment—other than
the personal satisfaction of learning how to live an honest and intimate
life—don’t take
anything for granted.
Legal
Cautions
Hypnosis
Once a client
has been hypnotized or given a sedative drug to enhance memory or
uncover
past experiences, he or she may not be allowed, in some states of the US,
to testify in any kind of civil or criminal proceeding. So if you expect
to initiate a lawsuit in the future, it would be advisable to consult with
an attorney before attempting any treatment that involves
hypnosis or hypnotic drugs to enhance memory.
Suing for
Compensation for Mental Suffering
In today’s
world, it often happens that a person who is injured by another party tries
to recover personal damages through a lawsuit (called a tort). If,
however, the injured person includes mental suffering as a basis for monetary
compensation, then confidentiality about any prior
psychological treatment is lost and everything about the past clinical
record becomes open to the court. So, if you have any history of psychological
treatment that might be embarrassing if it became public knowledge, you should
think twice about including psychological damage as grounds for any
lawsuit.
No
advertising—no sponsor—just the simple truth . . .
|
|
Notes:
1.
See Stewart, A. E., & Lord, J. H. (2002). Motor vehicle crash versus
accident: A change in terminology is necessary. Journal of Traumatic Stress,
15, 333–335.
Additional
Resources
Internet:
Association of State and Provincial
Psychology Boards — for the link to your state’s Board of
Psychology.
The California Board of
Psychology
Forensic Psychology
Index Page
Legislative Council Website —
the official site for California legislative information.
Related pages within A Guide to Psychology
and its Practice:
Confidentiality
Consumer Rights and
Office Policies
Diagnosis in Clinical
Psychology
Hypnosis and
“Negative” Hypnosis
Honesty in
Psychotherapy
Other Applications
of Psychology
Personality
Psychological
Testing
Questions and Answers
about Psychotherapy
Repressed
Memories
Types of Psychological
Treatment
The Unconscious
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