TRANSCRIPT
I would like to explore the ridiculous concept of mandating people to go to psychotherapy. When I first became a psychotherapist, back when I was a therapist, this goes back about 20 years. I was working in different clinics or interning in different psychotherapy clinics, and sometimes I was assigned, by no choice of my own, clients who had been mandated, who were forced to come to psychotherapy, perhaps by a judge or a probation officer or a parole officer or some other outside entity.
What I saw immediately is there was a huge difference between people who came to psychotherapy voluntarily and people who came to therapy because they were forced to. Sometimes, even with the people who were forced to come to therapy, I had to sign a piece of paper at the end of every session saying yes, they attended their session. And then I started thinking, well, am I a psychotherapist or am I really just a parole officer myself? Am I a probation officer? It’s like I felt like suddenly I was being like a policeman of these people, and I didn’t like it.
Also, what I saw is the people who were mandated to come to psychotherapy, they didn’t seem to like it either. They didn’t. And it totally made sense to me. They were supposed to come to me and open up and bear their soul and talk about their emotions and their feelings with someone who was being paid. Well, when I was an intern at first, I wasn’t being paid; I was actually paying for the experience. But fundamentally, someone who is being paid, who is a professional, who is there by their own choice, and this person is being forced to do it.
And then it brought back to mind, ah, actually when I was 13 years old and I got caught for fighting in school because I was acting out my rage about having been abused by my father at home and being bullied in school myself. I started fighting with kids. I had some anger issues; I had some rage problems. And I got mandated to go talk to the school psychologist, who I think everybody that the school psychologist talked to was mandated to come to her. And what a horrible person she was! Nasty. She didn’t care about me. I think she liked the power of having me forced to be there, and all she did was punish me. She said, “If you don’t do this, this is going to happen to you. If you do this, this will happen to you.” And that was her job as a psychologist, as a therapist. Even was she a therapist? I don’t really think so, even if she had that title.
Well, interestingly, when I first became a therapist, my first supervisor, who got assigned to me—I didn’t choose this guy; I didn’t like this guy. I actually thought he was kind of a jerk. Well, he bragged to me that he had a private practice because so many therapists, that was their goal: “I want to have a private practice. I proved that I can make it independently in the world.” Well, he bragged to me that in his private practice, he worked with all mandated clients. He worked with people who had been arrested for drunk driving, and the judge assigned these clients to come to therapy with him. They mandated him, so his entire private practice was mandated clients—people who came, had to talk to him, had to talk about their personal intimate problems with him. And he would sign a paper saying that they had come, and if they didn’t come, he said, “Oh, I’ll call their—I’ll call the judge. I’ll let the judge know, and they will get in trouble. They could go to jail for it.”
And then I saw it when I became a therapist for people like this in clinics. Their probation officers and their parole officers required me to check a box: did they come to therapy this many times? Maybe in 10 sessions, they were allowed to miss once, but if they didn’t miss, they could go back to jail. And I thought, why in the world would any client trust me? If I don’t check that box, they could go back to jail. That was horrible. And I had to fill out treatment plans for them: “You will talk about your feelings, and you will work on this symptom, and you will stay symptom-free,” and blah, blah, blah, and “you won’t refrain from it.” I was like, wait a second, this is disgusting. This is a misuse of my role. This is a misuse of the power of my role, and I didn’t like it. And yet these people were expected to bond with me.
My whole idea of being a therapist was that I would bond with people. I would try to minimize the power. I didn’t want to use my power against them. And yet what I saw is there were quite a few therapists at these clinics who liked working with mandated clients. And what I saw again and again is the people who liked working with mandated clients had less of an ability to bond with people in an equal way. These were people who got off on the power. Now, a lot of therapists get off on the power of being a therapist, of the role of it, of the grandiosity of it. But the folks who liked working with mandated clients, these were often the people when they had clients who weren’t mandated, those clients didn’t like them, and they didn’t come back. So it, in a way, was easier for these therapists to make a living with people who had no choice about coming.
Well, over time, I don’t know how many years did I work in clinics—four, five years about? I think it was about five, four and a half years. I still did get required to work with certain mandated clients. I often told my supervisors, please don’t assign me these people, but sometimes they did anyways. And what I realized over time—not how long, within a couple of years—is when I am assigned a mandated client, I would tell my mandated client, although we have to come up with a treatment plan and all these things that you’re supposed to do and what we’re supposed to do and talk about and what you’re supposed to work on, my attitude is because you are forced to be here, because you are mandated to be here, this goes against the very ideas of what psychotherapy is and should be. Therefore, I see there’s only one reasonable goal, one reasonable goal for the treatment of psychotherapy that we should put on your treatment plan, and that is that the only reasonable goal in psychotherapy here is that we need to figure out how to get this mandate revoked.
And then once we get this mandate revoked, then you will have the ability to personally choose and decide if you wish to continue psychotherapy. And frankly, I would not blame you at all if you quit the minute that your mandate is revoked. And my goal as a psychotherapist is to figure out how to help get this mandate revoked. I will write letters for you. I’m going to fight for you. Now, unfortunately, you’re being required to come because there’s going to be someone who checks, maybe even checks your insurance to see how often you come to psychotherapy. So please don’t put me in a position where I have to say you didn’t come. I don’t want you to come, but I expect nothing of you in terms of a relationship. And frankly, if you don’t want to talk to me at all, if you want to sit here and play computer games or do whatever you do or write letters to people or do whatever you want or sit in silence, I consider that totally reasonable and acceptable.
If you want to talk with me, you can talk with me. If you want me to talk the entire session, if you want to ask me questions and interview me the whole—you can do whatever you want with this time. I have no expectation that we need to use this time to build a relationship because you’re being forced to be here, and that is not fair. That is actually anti-therapeutic.
Now, what I saw when I told that to people is mostly what I found is they didn’t trust me. And guess what? Why should they trust me? Because at some level, I am participating in a system that’s manipulating them, that’s forcing them to make them do things that they don’t want. And I thought, and I even said that, I said, and by the way…
I’m saying this, but why should you trust me? Because you don’t know. You know that I have the power to write whatever I want in a little note to, or take, have a telephone call and call up your parole officer or your probation officer. I can screw your life completely. That’s the power invested in my role. So I think it’s quite reasonable that you don’t trust me.
But watch me over time. See if I prove trustworthy. And what I saw is over time, some of these people tested me. They did things sometimes that tested to see if I really was on their side or not, and quite reasonably so. Sometimes it was frustrating, sometimes it made me angry, and sometimes they really tested me. It made me want to, like, oh, I’m mad at this person. They’re doing, like, not showing up for session. They could screw them. Sometimes I felt like I liked them more than they liked themselves. They put themselves in a position where they could screw themselves, and it’s like, oh my god, don’t put me in a position where I had to write a letter.
Sometimes I would refrain from writing letters to parole officers for people who missed too many sessions. I didn’t want to give their parole officer ammunition to harm them. But what I saw a few times, not always, but I saw it a few times, is that I did win the trust, or maybe earn the trust. Earn the trust is a better word because I don’t know if I won anything. I earned the trust of a few people who were mandated to come to psychotherapy, and at some level they figured out somehow that I actually was on their side.
I never actually did screw over anyone. I never did anyone got anyone sent back to jail. I refrained from sending letters that could have hurt people. I just thought, wait a second, I didn’t come into this field to harm people. I refuse to do it. I don’t care even if it’s against the rules. I can’t do it.
But what I saw is a few times people actually bond with me, get something out of the psychotherapy in spite of a mandate. But it only came first by me just saying I refuse to use my power. I can’t use it. I hate it. Even though I have it, I don’t want to use it. People actually talking about stuff, bonding with me in some way.
But what I also saw, and I saw it I think pretty much almost every time someone was mandated to come to psychotherapy, is when I slash we figured out how to get their mandate revoked, they didn’t come back again. And I felt in a way good. It was almost like by them refusing to come to psychotherapy after they had been mandated. I think actually one guy came for one session after he’d been mandated. He just came to tell me, listen, you know this went better than I expected, but just out of personal self-respect, he told me I’m quitting. I’m going to come back one time and just tell you thank you. I appreciate you being kind of a cool guy for me when you could have screwed me over like so many other people have and other therapists probably would have. But just out of self-respect, out of the principle, I’m not coming back anymore.
I’m like good because you know I feel the same way. You know when I got forced to go to one psychology session when I was 13 years old, that one forced time was enough to make me at some level despise the mental health field, despise a psychologist who played along with those rules. I despised my first supervisor when he bragged to me about his private practice full of mandated clients when I worked at the clinics. And I saw some of these therapists who just had all mandated clients because no one otherwise in their right mind would have wanted to come and talk with this power freak immature therapist. Yeah, I got it.
And so it took me a long time before I went to therapy by choice, a good 13, 14 years before I tried it again. Incidentally, I found therapists who were not deserving of my trust. Sometimes they hooked me to come back in different ways psychologically and emotionally that in a way sort of was a kind of a mandate for me. Like I kept coming back to try to get their love or win their love, which they would never give. And that was sort of the hook that kept me coming back, a sort of subtle psychological mandate that I think a lot of therapists use.
But what I like the idea is if psychotherapy is going to be a good thing, which so often I think it isn’t, but if it is, fundamentally it requires two people who are both choosing to be there. And especially the client choosing to be there, wanting to be there for healthy reasons, knowing what they want to get out of this, or at least being able in a non-manipulative way to explore what they want out of this relationship and having someone who can really help them meet their own goals.