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.