Ethics, consequences, victims

Gideon’s little brother is a psychiatrist! Who would’ve thought it? Fair play to the plucky youngster, going against the family grain, dedicating himself to people instead of mone… Oh, hang on. No, Gideon’s little brother is the kind of psychiatrist you read about in Against Therapy – the kind you thought was a thing of the past. Gideon’s little brother has twice been reprimanded by the medical profession, once for falsifying prescriptions for and ‘escort girl’ (prostitute, no?) (6 month suspension(?)), and more recently for engaging in the archetypal therapist  whatever-you-do-don’t-do-this behaviour: having an affair with a patient whom he later dumped, then threatened in order to keep her quiet. She attempted to take her own life on three occasions following the end of the ‘relationship’. To me this is akin to a secondary school teacher taking advantage of a sixth-form student – it has the same power imbalance and, depending on the patient, a similar degree of vulnerability. I’d expect a custodial sentence. He didn’t get one. He got barred from working as a psychiatrist again (good) at a hearing he didn’t even have to turn up to (bad). He has ruined someone’s life through the wilful disregard of pretty much every rule in the book, and doesn’t have to face any serious consequences.

The case reminded me of the kerfuffle over Hogan-Howe and the over-zealous investigation of child-sex allegations. I don’t want to get into the rights and wrongs of the way that “believe” is interpreted by idiots, or the, in my mind pointless publishing of suspects’ names. What I’ve found anger-making is the way the story so easily focusses on high-profile establishment victims (retired heads of army, etc), and finds it so hard to focus on the many thousands of voiceless victims, who continue to be abused and unheard. Yes, it’s bad that your man who was a rank in a thing wasn’t told that the investigation had been dropped. It sounds horrible; I can’t imagine the disruption to his and his family’s life. Honestly, awful. I’d not wish it on anyone, and it was handled badly. But it just does not compare in any way at all to the experiences of those children who have been abused by high- or low-profile adults. The time given to each is hugely disproportionate, and, frankly, cowardly in the extreme. The space given to the victim of Gideon’s little brother’s callous misconduct is tiny – the extent to which justice could be said to be done by his disciplinary hearing is non-existent.

Anyway, in amongst all of this slightly coherent anger at the way that the disempowered are ignored as soon as they can be, I felt a warm fuzzy feeling that I am now working in a profession (counselling; very different to psychiatry) that takes its ethics seriously. Engaging with the ethical framework and reasoning our way through dilemmas related to this was a large part of my training as a counsellor. Unlike the psychiatrists who are only out to protect their own, our conduct always comes back to the client at its centre: we are governed by the interests of the person who has the least power and the quietest voice. Warm and fuzzy I felt to belong to a profession which takes its ethics seriously. So seriously that, as trainees and recently qualified counsellors we’re terrified of trying anything new or different or client-led, because the sanctions for behaving unethically are, we imagine, so stringent.

Warm and fuzzy, then, until I saw this – the proceedings of the disciplinary panel of the BACP (for anyone who doesn’t know, the BACP is the de facto regulator of the counselling profession. Joining it is not mandatory, but it’s exceedingly difficult to get a job if you’re not a member). I expected to see lists of people being struck off, referred on to criminal hearings, or, if culpable of lesser misdemeanours, having their work monitored and their fitness to practice rigorously assessed. I expected to be able to read these in an easy to find part of the BACP’s website – they don’t appear in the magazine because presumably they’re too numerous. But no, what I saw instead (and you can see too, if you can battle your way through the deliberately hard-to-read pages of tiny, awfully-written text, found in a shed round the back of the website) is a list of people who behaved pretty awfully being given essays to write.

Essays.

“What you did was wrong, and I hope you’re very ashamed of yourself. Now I want you to write me 1000 words on the subject: “Why what I did was wrong, and why I promise I won’t ever do it again'”.

It sounds like I’m joking, but I’m not, Yvonne. Yvonne took in a client who had recently had a stillbirth. The client was told she was an expert, and presumably hoped to work through some of her traumatic experience with Yvonne’s help. When Yvonne arrived, though, Yvonne spent the first 15 minutes telling her client about her broken leg, and how she got it on holiday. When the client tried to turn the conversation back to her stillbirth, Yvonne went on to describe the unsatisfactory experience she had at hospital with her broken leg. Other things happened which I can’t even grasp as the report is written so thickly.

Not abusive behaviour, Yvonne, but I certainly wouldn’t want to go to see you if I were in a vulnerable state. Nor do I want to belong to the same club as you. Fortunately the client complained and her complaint was upheld. I’d presume that she’d be removed from the BACP until such time as she could demonstrate her fitness to practice. Or that she would be required to work with someone monitoring her practice to ensure she was not continuing to practice in this harmful way. But instead she’s told that unless she writes an essay in the next six months and say you’re very very sorry, she’ll have her membership to the BACP revoked.

I don’t want to come across too facetious here: regulation is a difficult and complex question. I like that counselling is not regulated by government. Having experienced ofsted in education I know that the evils of over-regulation far outweigh the evils of self-regulation. And, to be fair to the BACP, they do revoke your membership if you fail to write the essay, have an affair with a student (I’m looking at you Mr Pickles) or are convicted of child sex offenses (Mr Fothergill). That’s something, but it’s not nearly enough. The hidden, apologetic, essay-requiring approach by the BACP feels so very self-serving.  An organisation which was set up to serve clients rather than counsellors would shout from the rooftops about its investigations and be ruthless in removing or retraining counsellors who are incompetent and dangerous. It does neither, and thereby lets us all down.

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