by Tory Butterworth
A couple of weeks ago on the TV show, "Criminal Minds," a profiler was approached by a High School student who was afraid he would murder someone. Later in the show, a different profiler evaluated this young man and said, "In my opinion, it's not if he'll kill, it's when."
This episode illustrates one of my quandaries in writing this blog. I've been considering blogging on diagnoses such as "bipolar" and "schizophrenia" which get bandied about on TV, often incorrectly. I've hesitated because I'm afraid readers will assume I'm someone who specializes in criminal minds. As a therapist, I work with the mentally ill. As a group, the mentally ill are somewhat more likely to be violent than people who are mentally healthy. However, most mental patients (90% or so) aren't violent.
In the orientation group I co-led at a community mental health agency, we quickly learned to screen out the criminal population, sending them to the forensic treatment unit. I discovered that in establishing a therapeutic alliance, I assume a basic truthfulness from the client. If someone told me the FBI was after them, I wouldn't necessarily believe they were being chased, but I would assume the client thinks he or she is. With forensics clients I learned to assume they were lying in order to pull off a scam. My first job when working with them was to figure out what they were trying to get away with.
Forensic patients are masters at scoping out a group, identifying like-minded individuals, and forming alliances to help them undermine the authority of the group leaders. Amazingly, they were often able to pull this off in a single two-hour group session. The bulk of patients who come more or less willingly to community mental health, not forced there by a court order, were focused on their own pain and didn't have much attention left for others in the group. Most of them lacked the social skills to form a rebellion even if they wanted to start one.
Getting back to the "criminal minds" episode, the profiler who performed the evaluation didn't realize the mistake he was making in predicting future behavior. His job starts with a past act, a murder that's already happened, and he works backward to identify who did it. He rarely meets the 100 to 1000 people that match his profile who haven't killed anyone. He doesn't collect data on what differentiates them from the killers.
The fact this young man, frightened of his own impulses, was looking for help before he'd killed anyone, speaks to me of something in his character that differentiates him from those who take out their sadistic fantasies on others. Clients who are successful in therapy have to look at their own pain, rather than blaming it on others or covering it up with unhealthy behavior. This act of moral courage often differentiates those who remain sick from those who get better.
As a therapist, I'm predicting I could work with him.
8 comments:
Great post, Tory.
The problem with TV shows is that they are on to entertain. If they portrayed what really happens, no one would watch. It's even causing problems in the courtroom because juries think all the evidence should be just like on CSI. Maybe every year, these shows should devote one episode to how things happen in real life.
My daughter is currently working in an ICU unit from which few patients emerge miraculously. One of her biggest challenges is helping families through the end-of-life issues that most refuse to consider--because TV shows tell stories of miracle cures in every episode. It's made her job much tougher.
Thanks for this blog, Tory. It's a guide for writers who employ therapists in their books.--Not all therapists are capable of coping with Hannibel Lechter!
Kristine: maybe it's an indirect compliment, they expect book authors to be smarter?
Joyce: Maybe TV shows need to start with a qualifier, "Certain details have been changed to protect from boredom."?
Nancy: That's similar to my research job, getting renal dialysis patients to talk to their families about end-of-life treatment. TV shows can bias the ways we see statistics. If a doctor says, "S/he has a 1 in 100 chance of survival," families often think that means they have a running shot. Really, that's doctor's way of saying, "There's no hope." Maybe another blog on that some day?
Well said, Tony. As a licensed investigator specializing in computer forensics and electronic evidence, I am still struck speechless at some of the things seen on shows such as "CSI", which give a *very* skewed impression to potential clients. More than once, I've explained a full bore examination of a subject hard drive can and has taken more than 40 hours, I can almost count on a stunned gasp and "But, on CSI, they do it in five minutes". It's reached a point where prosecutors have come to fear what has been termed "The CSI Effect" on jurors.
It's scary. Very scary.
William, I read an article recently about the CSI effect http://www.usatoday.com/news/nation/2004-08-05-csi-effect_x.htm.
Jurors expect a preponderance of physical evidence, which in most cases, doesn't exist. Not every case has DNA, fibers, hair, etc.
People also expect more from the police in regard to investigations. We had a person who had their car stolen and recovered and they didn't believe it when the officer told them there wouldn't be an investigation. The guy wanted someone to print the vehicle and "collect evidence," just because they do it on TV.
Rob: I wouldn't diagnose the character portrayed on "criminal minds" was an antisocial personality disorder, psychopath, or pediophile. I don't work with forensic clients, so I don't know success rates on them.
However, I would be willing to work with this client because he appeared highly motivated to change. I'll go out on a limb and say that motivation to change is the largest single factor in whether I can help someone or not. Unfortunately, antisocial personality disorders, psychopaths, and pediophiles are rarely motivated to change.
And I hope people don't get the idea the point of my blog was to trash "criminal minds." I like the show and I found the episode rivetting. I think discussing a show afterwards is probably the best compliment you can give it.
Meryl: thanks for chiming in!
Lumping Jeffrey Dalmer and your friend who suffers from depression into the same bag of, "people with mental illness," is doing both a huge disservice!
Screenwriters are notorious for inaccuracies, and admit to taking little time to ensure their depictions are accurate, thus giving others in the writing profession a blackeye. Unfortunately screenwriting is pretty much a closed shop and any chance of making substantive inroads, and thus influencing change, are minimal at best.
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