Oh, no. That is SO wrong!

I'm reading the Sunday paper this morning and I'm all like, wha-a-at??

It seems that transcripts of some of Carson McCullers' sessions with her therapist are being released to researchers, and everybody's all excited about how this will give them more insight into her life and art. Well, not everybody. I'm certainly not.

I'll give the therapist a pass on terminating the therapy relationship so they could have a personal relationship. This was the '50s, after all, and things were different then. In fact, they were so different that she might actually have been a bit ahead of her time in that regard. Most people back then didn't bother terminating one relationship before beginning another. I remember when I was just a young sprat of a therapist reading about one famous, leading psychologist who was therapist to a young woman, then her professor (presumably he mentored her into grad school), then her clinical supervisor -- and then her husband! Not sure when, exactly, they became lovers, but good grief. That's like a perfect trifecta of "dual" relationships.

But McCullers' therapist/partner lived until 2013. By which time it should have been glaringly obvious to her that those transcripts should have been destroyed -- back in the 60s, not to put too fine a point on it.

And the university that inherited and is releasing them bears some responsibility here, too, even though the actual custodians are likely academics in literature, not psychiatrists. They should have quietly destroyed them as soon as they realized what they had.  

If Everybody Did

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Tax day is coming, the W-2s and 1099s are rolling in, and in the midst of the usual bitching about paying them, I heard one fella actually brag that he did not report cash income. Which put me in mind of people I have known who claim bogus deductions. I myself, while reporting honestly, am more often late than not: Indeed, I would venture to say that I have probably filed nearly as many requests for extensions as I have actual returns. What is all this resistance about?

The tax complainers seem to see taxes as some kind of terrible, unfair imposition, as if (a) they had nothing to do with electing the governments that assess them, and (b) they never use the services the taxes pay for. They complain about how the money is spent, without much actual awareness of where it really goes. About a fifth, for example, goes for Social Security and Medicare, both of which these folks will apply for the day they become eligible. They elect a government that takes us on military excursions overseas and then resent ponying up their share (almost another fifth of the national budget, not including veterans' benefits) every April. These same people send their kids to public schools and will not hesitate to call the police if their office is burgled, while resenting paying their fair share for these services via sales, property, and other local taxes.

A couple of years ago, the IRS released results of a survey in which about 84% of us said it was never ok to lie on your returns. From that, researchers assumed that about 16% of us cheat. I would bet that there's another few percentage points at least comprised of those who say one thing and do another. Add those together, and you get at least a $345 billion (yes, that's billion) shortfall in any given year. Approximately 3/4 of government borrowing goes to make up this shortfall, adding to the deficit every year. Is it any wonder that early in the wars we saw stories about soldiers' parents having to purchase and ship body armor out of their own pockets? Or that programs and services are being cut or terminated because of lack of funding?

Besides being illogical and selfish, it's unethical to lie on your tax return.

When I was a little girl, someone gave me a book on ethics called If everybody did. The gist of it was that there were some things one person could do once that had small(ish) consequences, but if everybody did it, well, then. . .

 

Kant for short people

That question has been an ethical touchstone for me all my life. When I remember to ask the question and really listen to the answer, I rarely make a false step. When I don't,  the results are about what you'd expect.

I've been thinking a lot about that little book lately.

What if everybody who ever accepted cash for their work did not report it? What if everybody put their personal dry-cleaning bills, club memberships, and even church pledges down as business expenses? What if everybody claimed everything they bought at the drugstore, from magazines to shaving cream, as medical expenses in order to get the itemized deduction? And before you ask, yes, I've personally known people who've done every one of these things. Where do you think the the money would come from to treat injured veterans?  to pay for your Daddy's nursing home?  to upgrade the armor on that HUMVEE your cousin's riding around Afghanistan in?

When you cheat on your taxes, you are not cheating the IRS. You are, in effect, cheating your fellow citizens. Your coworkers. Your neighbors. Your children. Your parents.

The irony is that none of these people think of themselves as illogical, selfish, and unethical, or as liars, cheats, or criminals, despite the fact that they are every one of these things.

The whole system is based on self-reporting, on trust. If everybody lied and cheated, it would collapse. If everybody dragged their feet like I've been doing, we'd have to borrow even more every year to keep the government running (10% of the budget every year goes to interest payments as it is). The IRS would have to audit everybody, or maybe they would require all our patients, customers, clients, etc. to start issuing us 1099s at the end of the year. Or maybe we'd just go back to the system of old, when the government just showed up at your front door and took what it needed at the point of a spear. How would you like that?

So you just think about that the next time you are tempted, as a former colleague liked to put it, to "round things off at the corners". I know I'll be thinking about it this spring when the temptation to procrastinate arises.

What if everybody did?

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• Why we cheat on our taxes (msnbc.msn.com)

#7: Patience is a virtue

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Patients occasionally (okay, frequently) express impatience with their progress in therapy. Impatient with themselves, they become impatient with me for not fixing them faster. And they worry that perhaps I am impatient with them for not doing more, better, faster than they actually are. 

Wood's Rule #7: Patience is a virtue

Because cultivating this virtue helps you "cease contributing to your own suffering and confusion and perhaps to that of others", Jon Kabat-Zinn¹ describes patience as a "fundamental ethical attitude" (1994, p. 48).

"From the perspective of patience," Kabat-Zinn writes, "things happen because[emphasis added] other things happen" (p. 48). You get sober, whether sooner or later, because you got drunk. The teenager you've brought to me for therapy will develop maturity and judgment (eventually) precisely because he has been immature and impetuous. For that matter, we can only learn patience who began our journey with impatience.

And if that is true, then it is also true that

what will come next will be determined in large measure by how we are now. This is helpful to keep in mind when we get. . . frustrated, impatient, and angry in our lives (p. 50). 

What will being impatient and irritable right now this two seconds create in our next few minutes, days, weeks, or months? Years down the road, what quality of life will all this rushing around and crankiness have produced for us?

So I would remind my patients to, in Kabat-Zinn's words,

. . . [remember] that things unfold in their own time. The seasons cannot be hurried. Spring comes, the grass grows by itself. Being in a hurry usually doesn't help, and it can create a great deal of suffering--sometimes in us, sometimes in those who have to be around us (p. 48).

It's how I think of you when you are struggling, when you have hit a wall. I know that I cannot make a flower bloom, or control its form and color when it does. All I can do is make sure to plant it where it receives enough sunshine (but not too much); then I must water and fertilize it (but not too much). It grows on its own, in its own time and in its own way. And so will you, dear, so will you.

Kabat-Zinn closes this chapter, poetically titled "The Bloom of the Present Moment", with a quote from Lao-Tzu:

Do you have the patience to wait
till your mud settles and the water is clear?
Can you remain unmoving
till the right action arises by itself
                            -from the Tao-te-Ching 

If I allow myself to become impatient in session, then I act before my mud has settled. It is not likely that anything that I do will come out of right mindfulness or right understanding. To the contrary, it is highly likely that I will do something to make your journey harder, or longer. And that would be unethical.

 

1. Kabat-Zinn, Jon (1994). Wherever you go there you are: Mindfulness meditation in everyday life, pp. 47-51. Hyperion: New York.

I feel like I need a shower now

A recent thread on a professional listserv I belong to has taken up the topic of using client/patient testimonials on psychotherapy websites, in brochures, and for other marketing materials. A couple of people responded to the original poster that he should not do it. And then this:

My [partner] is an attorney and we looked into this before I obtained my testimonials. It is true that in [State] testimonials are not allowed regarding current clients. However, clients that you have terminated with are fair game.

"Fair game"? Egad. What a way to look at one's patients. Would you want to see a therapist who looks at you as the marketing equivalent of a deer in his crosshairs?

The commenter goes on to say,

Some of my clients fill out a form. . . and some I speak with over the phone. The phone interviews are much more productive because you can discuss what may be relevant to your marketing needs, e.g., getting them to talk about specific results that have come from our work together rather than just praise about me.

Finally, the commenter refers the original poster to the website of a practice coach who says, and I quote:

. . . through the course of your work together perhaps a client spontaneously expresses how he or she is benefiting from seeing you.

When this happens, you should write down what the client said about how he or she benefited from your service and then ask permission to use these statements in your promotional materials.

Seriously. I need a shower.

As the commenter notes, certain states' licensure laws do not expressly prohibit soliciting testimonials from former clients. Our ethics code does not specifically forbid it either. However, it is my position that ethical behavior ought to consist of more than simply not doing what is expressly forbidden. Striving to be as ethical as we can should include having our clients' best interests at the forefront of our minds at all times, acting like a professional (as opposed to, say, a used-car salesman), and maintaining our professional objectivity in any given case. It is a vital part of our professionalism and essential to our objectivity that therapy is about the client's needs, not ours.

Taking notes during a session with an eye to posting clients' statements on your website is hardly keeping your eye on the therapeutic ball. Even if you wait until a client is "former" to ask permission to use a quote, how can you help but think in terms of that client's potential effect on your bottom line rather than doing your best work at the moment? Sometimes our best work is going to make the client uncomfortable--anxious, sad, even angry. We may hesitate to say what they need to hear, as opposed to what they want to hear. What if a client wants us to violate a boundary in some way? We may give in, gratify that wish for them instead of helping them work it through, so we can get a good ad out of it. We're only human: If we walk into that consulting room with any agenda other than the therapy, we are at risk for skewing things to get our needs met at the client's expense.

Waiting until the client is no longer a client to ask for a testimonial does not keep it from being an issue with active clients. Clients who found you through promotional materials using testimonials know perfectly well, even if you haven't mentioned it yet, that this is on the table. How will this affect their work with you? Will they use criticisms for leverage? Will they worry that if they don't give you a testimonial that you will not write as good a letter for their probation officer, or give them whatever else they are needing from you? Conversely, will they spontaneously offer testimonials in order to win your good will? Clients know we're only human.

Clients who form strong, long-term relationships with their therapists are particularly desirous of pleasing us. Might such a client be even more reluctant to hide relapses if they have the extra, added pressure of knowing we need a success to bolster our practices? Could they feel pressured to look like they are getting better than they are, faster than they are, to help us out? Nobody knows the answers to these questions, because nobody's researched it. It would be unethical. But we can make educated guesses, and our best guess is that any or all of these things could happen; our best guess is that this testimonial business is bound to affect the work. It can't not.

Our ethics code and state law do prohibit soliciting testimonials from "persons who because of their particular circumstances are vulnerable to undue influence." Many therapists think that this latter category includes former patients. We are uncomfortable with the legal and ethical distinction between current and former patients that allows certain behaviors toward the latter. Psychodynamic therapists argue that transference, the displacement of feelings from parent to therapist, lasts forever. To them, "once a client, always a client" is the rule. Even if you aren't psychodynamic in orientation, it is difficult to define "former." I've had clients return after a hiatus of as long as 10 years, and probably these folk considered themselves my clients even when they weren't active in therapy.

Contact after a brief period is very common. Perhaps the client you just saw for a 5-session Employee Assistance Service (EAP) assess-and-refer gives you a testimonial--or refuses one--and six months later needs you to testify to your work in court. Will you be squeamish about testifying to things that will hurt your client's case? Will you not want to go if they wouldn't give you a nice sound-bite for your website?

Even if they never come back or need you again for anything else (like court), on what magic date do you stop having most of the power in the relationship such that a client would truly feel free to refuse you? There is no research that I am aware of which would tell us how many days, weeks, months, or years it takes after therapy ends for us to stop being an authority figure to our clients. On what magic date would we no longer be using our position and prestige to get our "marketing needs" met by the client? By the time we get done with a course of therapy, we know things about a person, things we can use to get what we want. On what magic date to we un-know these things? I think the commenter above intuitively recognizes, even as she fails to consciously consider, that power when she recommends telephone interviews: We can exercise a lot more influence, due or otherwise, on the phone than we can through the mail.

The American Psychological Association (APA) ethics code also forbids dishonest or misleading public statements, in which they include your advertising. There is plenty of research to show that, psychologically, humans want things to work. We are hard-wired to believe that a treatment or a product did work for us, and the more time and money we put into it, the stronger is this bias. Asking a client if something was helpful is not going to get the same kind of objective information as, say, before-and-after psychological testing might. Plus, presumably, if a client tells you, "Heck no, you bite," are you going to post that on your website? No. For these reasons, your promotional materials are apt to be misleading, if not downright dishonest, in direct proportion to your dependence upon testimonials.

Bottom line? Just because we can do a thing doesn't mean we should. What we should do is strive to go as far beyond the minimum standards outlined by legal and ethics codes as we possibly can. I simply do not believe that we can do our very best possible work if we are thinking about how what we are doing is going to look in a brochure, and I do not believe for one minute that clients will have the freedom of action or sense of absolute privacy that are the sine qua non of productive therapy if they know they will be used in an ad. There is a risk throughout the therapy and well after it that we will be using our position as the client's therapist, and the power and insider information that goes with it, to get our needs met. Finally, testimonials are not an honest means of advertising.

I tell my ethics students that, "There's illegal, unethical, and just plain tacky." Testimonials may not be illegal, and they may not be unethical, but they are surely tacky. In fact, I would go so far as to say that they are downright sleazy.

Just sayin'.

Busted!

A psychiatrist who practices at Peachford has been indicted for sexual exploitation of a patient. Psychologists' ethics specifically forbid sexual relationships with patients, as does Georgia law, and as do most professionals' ethical codes--for good reason. The doctor-patient relationship, whether the doctor is a doctor of medicine or a doctor of psychology, is not an equal relationship and gives the doctor the power to engage the patient in activities that are not in the latter's best interests.

Adult patients who are exploited are usually female, and there has been some argument that such an ethical/legal prohibition is therefore sexist. It has even been said that, male or female, such prohibitions might deny adults their constitutional right to freedom of association. But studies of this issue have consistently found that it is not usually a case of two consenting adults falling in love (or lust) but rather one in which the therapist has serial affairs with patients, acting out her or his own issues in the treatment, much to the detriment of the patients. So I'm gonna go out on a limb here and predict that now that his mug has been on the 6:00 news, there will be more patients coming forward to report that they, too, have been taken advantage of in this fashion.

Often, it is not until someone else files a complaint that a patient realizes that s/he has an unethical therapist. In the first place, some such patients have been abused before (e.g., incest survivors) and have very poor boundaries to begin with. Their idea of what is abnormal is way, way out there, based on their growing-up experiences, and a little kiss or a date with a therapist doesn't even come close to tripping their radar. To them, this is business as usual. Therapists who are sexual predators in this way are no different from child sexual abusers in that they have a well-honed instinct for who is exploitable. Is this client emotionally needy? Does this client lack a good support system? This re-traumatization is an especially awful betrayal of what to my mind is a sacred trust placed in us.

Seduction by a therapist then proceeds in much the same way as an adult/child exploitation: Early inappropriate behaviors are highly deniable and serve as a test of what the therapist can get away with. Test behaviors also serve to 'groom' the victim, as the therapist (like any sexual predator) gradually increases hir demands. The victim is sucked in one small step at a time, and by the point that s/he feels things are badly out of whack here, s/he (a) is too far from the exits to be able to extricate hirself, and (b) has come to feel complicit in what is going on so is too embarrassed and ashamed to tell anyone. Plus, these therapists, like all sexual predators, instill the importance of secrecy in the victim's mind long before reportable, criminal behaviors occur.

In some cases, the therapists told the patient that this was part of their treatment. For example, the therapist may tell the patient that s/he needs the experience of feeling attractive, lovable. Or that sexual inhibitions can be worked out in therapy by having sex. An unsophisticated patient really has no way of knowing any better: S/he trusts the doctor and complies. This is so not a love relationship, people. It is an abuse of power, pure and simple.

This particular psychiatrist has also been charged with inappropriate prescription practices. Reading between the lines, I'm guessing that the drug was part of the exploitation. This can happen in one of two ways: First, the drug impairs the patient's judgment. Second, the patient may become dependent upon the drug, and by extension, the psychiatrist. This is especially an effective trap if no reputable psychiatrist would prescribe the particular drug, or so high a dose of it--the client has become addicted to it and can only get it from her perpetrator. If she reports him she loses her source. See what I mean about power?

Psychologists' ethics do allow for relationships between therapists and former patients under certain conditions and after a certain period of time has elapsed. This, too, is controversial. These rarely (if ever) turn out well because the power imbalance from the original relationship persists. The roots of these relationships are in transference-countertransference manifestations that were never properly worked through in the therapy, but which, instead, are now being enacted outside the therapy. By definition, then, the therapist wasn't doing hir job in the therapy, and the patient by definition got short-changed.

These are the same interpersonal relationship dynamics that probably brought the patient to therapy in the first place: If they caused the patient problems then in hir relationships, they will cause problems in this one. Similarly, the therapist's lack of self-understanding, poor boundaries, and behavioral disinhibitions exhibited during treatment spell disaster for any outside relationships as well, including especially one with a former patient. Two such relationships of which I am aware became physically abusive; in one, the patient wound up killing hir former therapist in self-defense--and went to prison for it. In a third case, the pair got married, the therapist made the former patient hir office manager, and then proceeded to be unfaithful--with patients!

There are cases in which the patient initiates sexual contact. This is no defense of the therapist: Freud long ago recognized that when the patient falls in "love" with the therapist that it is not the therapist the patient loves--and that the therapist would be a fool (not to mention an under-analyzed narcissist) to think so. The patient/victim in some of these types of cases has been previously victimized, and presents with all sorts of sequelae of previous abuse that makes hir more likely to sexualize the therapy relationship than a patient without an abuse history. When such a patient introduces sex into the mix, it is clearly a therapeutic issue and should be analyzed, not acted out. And it is the therapist's responsibility to make sure that this happens. As one of my clients is fond of pointing out, "That is what you are getting paid the big bucks for."

The ethical and legal prohibition against sexual relationships with patients is a sound one. No good can ever come of it, no matter the participants' rationalizations to the contrary. If your therapist has said or done anything even slightly sexual before, during, or after one of your sessions, run like hell in the opposite direction. And please consider filing a report with hir licensing board and/or the Ethics Committee of hir state and national professional associations. The affirmation that your therapist was in the wrong will do you a world of good.

Homosexuality was removed from the Diagnostic and Statistical Manual list of psychiatric disorders in 1973. On August 14, 1997, the American Psychological Association (APA) Council of Representatives passed, by a vote of 10 to one, a resolution against so-called "reparative therapy" for gays. The first "whereas" makes crystal clear our view, as a profession, of this type of "treatment":

Whereas societal ignorance and prejudice about same-gender sexual orientation put some gay, lesbian, bisexual, and questioning individuals at risk for presenting for "conversion" treatment due to family or social coercion and/or lack of information . . .

And yet.

And yet, more than ten years later, there are still folks out there who think they can and should "cure" people of being gay. Or bi. Or transgendered. Twisty Faster, over at I Blame the Patriarchy, or IBTP for short, has brought to the attention of Blamers worldwide this BBC report on a study just out about some retro Neanderthal types in Great Britain. The journal, BMC Psychiatry, is open access and you can read the entire study here. The study reportedly found that, if asked by the client to do so, 17% of the mental health professionals surveyed would attempt to help a client change her or his sexual orientation*. The authors' conclusion?

Given lack of evidence for the efficacy of such treatments, this is likely to be unwise or even harmful.

"Likely" to be unwise? "Or even" harmful? You think? This lukewarm disapproval is bitterly disappointing, to say the least. Such practices are deemed unethical if not downright abusive (I believe the American Psychiatric Association uses that word) by every major professional group in the United States, Canada, and Great Britain that I know of, and I assume in most other progressive societies. I wish that the authors had unequivocally condemned such behavior, called for more education of the holdouts, and stern discipline of those therapists offering such "treatments".

The authors note that this is a "significant minority" but again, I think they are under-reacting. That one in six British therapists may have attempted to "cure" somebody's sexual orientation is scary. As the writer of a student dissertation on a related topic pointed out, this reveals a really serious problem with these people's training and ethics. It points up serious failings in training programs and in our ethical oversight of our peers. In other words, this is a problem for the profession as a whole, and it is a big one. The estimates of the proportion of therapists who violate sexual boundaries is, by comparison, much smaller, but our profession has generated reams of ink on why they do it, how to stop it, the effects on the victims, and so forth. If this kind of abuse is so much more frequent, how come it's not getting the same attention?

And according to the BBC, another group of researchers is trying to collect "stories" of successful changes via a website. I couldn't track them down, so I can't tell you anything else about it. But lord, lord. Does it never end? How can any ethical psychologist contemplate conducting research into unethical treatments? How can the rest of us, as ethical psychologists, countenance others doing it? And who the hell is funding this garbage?

They just don't get it. Except for one pretty seriously flawed study, there's no evidence that this even works, never mind that it is the right thing to do. Unfortunately, some groups advocating reparative "therapy" have seized on that one. It was published in 2003, by Robert Spitzer, in the Archives of Sexual Behavior. Spitzer asked, "Can some gay men and lesbians change their sexual orientation?" His answer was a qualified "yes," and it sparked a storm of criticism (26 letters to the journal, which is almost unheard of) and outrage.

Spitzer interviewed 200 self-selected reparative "therapy" patients and reported that the majority reported achieving re-orientation to at least "predominant" heterosexuality that lasted more than five years. At what cost to their general mental health? He didn't ask. Besides that little omission, his study was criticized for its sampling method (subjects were self-selected) and for its reliance on self-report.

It has been long established scientifically that there can be extensive differences between potential subjects who do not participate in a study and those who self-select in. It is also long-established fact that people in similar situations are motivated to perceive change in the desired direction. These clients after all have spent money and time in therapy to change, and their views of what they got from these efforts are going to be biased accordingly. Spitzer's data would have been a lot more credible had he studied all the clients of a given treatment program or programs and had he obtained objective before-and-after assessments. In short, it's lame even as pilot studies go.

He's not a bad guy. But I think he exhibited terrible judgment in conducting this study. If we are going to study treatments that have already been declared unethical, of "problems" that have already been ruled not problems, then we need to be focusing our money and our time, effort, and talents on exploring the damage done by those treatments and how, if it's possible, to undo the damage to their victims. But nobody asked me.

That same year, another group published a study of a more general nature, also using survey data. This one, "Predictors of psychotherapeutic benefit of lesbian, gay, and bisexual clients: The effects of sexual orientation matching and other factors," was published in 2003 in Psychotherapy: Theory, Research, Practice, Training. Note that the authors were not specifically investigating reparative therapies, but therapy for LGB clients in general. These authors found that

Negative predictors include having a therapist who is an analyst, who uses reparative therapy, or who violates sexual boundaries (p. 289).

A quick check of PsychLit tonight produced no additional published research, only a how-to book containing "personal testimonies" and one single-case study (by an analyst). In short, no one advocating this practice is producing any real data to say that it works. (Spitzer, it must be noted, is not an advocate. He just thinks we need more data, which is hard to disagree with, except I just have to ask, "Man, if it's not a disorder, why do we give a rat's ass whether you can cure it?") Plus, those advocating this practice are proceeding on the clearly-stated assumption that being gay is dysfunctional, which assumption no professional group of which I am aware accepts.

If being gay, bi-sexual, or lesbian is normal, which the helping professions all now agree that it is, then buying into the client's desire to change it is buying into their internalized homophobia. (I'm not even going into forced treatment of children and adolescents: That's a whole 'nother rant.) It is agreeing with them that a core facet of their very identity is something to be disgusted by and ashamed of. Therapists like the 17% in the Great Britain survey may claim the best of intentions, but in fact are using their power as credentialed healers to do severe damage to suffering individuals who instead need to be relieved of their shame, not their orientations.

One of my absolute favorite clients made her first call to the office to ask The Question: "My son needs a therapist. But he is gay and before I make an appointment with you, I want to know how you feel about that." Usually, that question is code for, "Our kid just came out to us and we're in total panic and want you to fix him/her now, if not sooner." It's a hard question to answer, not because I don't know how I feel--I do--but because I want that teen in therapy with me. The last thing I want for him or her is for ignorant, homophobic parents to keep calling around until they find a therapist who will agree it's just a phase, a fad, or something to be cured. So I took a deep breath, and answered, as I usually do, "That's like asking me how I feel about gravity, or the weather. It just is what it is. May I ask why you want to know?" When the parent(s) tell me that they want treatment for the gay-ness or the trans-ness I do my best to educate them and get them to schedule an intake. Sometimes it works, sometimes it doesn't.

This mom, God bless her, laughed out loud, and said "Good! Because being gay is not his problem and I didn't want a therapist who would assume that it was." And we scheduled an appointment.

We did talk about being gay in that young man's therapy, because his father wasn't quite 100% on board with it, and because his school allowed bullying to continue unabated--even blaming my client for coming out at school (he didn't, he was outed). He was already well wired-in to the gay community, so he didn't need any pointers there. What he was here for was his obsessive-compulsive anxiety disorder, and that is what we focused on.

And that is as it should be. Any therapist who attempts to make a lesbian's or gay man's orientation an issue any more than a straight patient's would be ought to be taken to the ethics woodshed. Same goes for any therapist who would make an issue out of a transgendered person's identity: It should be no more of a factor in the therapist's mind than a straight client's gender identity would be, except for the obvious--that LGBT clients are a harassed, discriminated-against, abused, and not-infrequently-murdered-for-it minority who also suffer internalized homophobia. And those problems certainly should be at the top of a therapist's list of issues to deal with.

*A student at Kennesaw State is conducting a similar study, but asking whether therapists think a long list of practices associated with reparative therapy are ethical. To me, it's not up for discussion (this is Ethics Codes for Dummies) and I'm more than a little uncomfortable with the study for that reason; nevertheless, it will be interesting to see whether his results tally with the 17% of the other study. I'll keep you posted.

That's Cynical

Thanks--sort of--to Twisty for the heads-up on Lay's new advertising campaign. The ad itself is insulting to women. As a psychologist, however, I'm also interested in this neuro-marketing stuff in the New York Times article.

In brief, it seems that women snack a lot, but "61 percent of [our] snacking includes drinks, fruits and vegetables". Stuff that's good for us, in other words. Frito-Lay wants to convince us that we should be eating unhealthy stuff--like their "salty snacks". No surprise there: We know marketers exist to convince us to buy things we don't need, right? But this is so cynical, and so obviously bad for us, that it blew my mind.

According to the Times:

Neurology used for advertising purposes, called neuromarketing, has gained a following among some marketers. Many use it to test their ads, using research firms . . . to show an ad to consumers and see the level of brain response.

One firm "began by researching how women’s brains compared with men’s, so the firm could adjust the marketing accordingly." That is cynical. Worse, it's pop neurology, grossly oversimplifying the research findings. The marketer in question assumes that because

the communication center in women’s brains was more developed . . . women could process ads with more complexity and more pieces of information.

A memory and emotional center, the hippocampus, was proportionally larger in women, so [Marketer] concluded that women would look for characters they could empathize with.

And research [Marketer] read linked the anterior cingulate cortex, which processes decision-making and was larger in women, to feelings of guilt.

Not to repeat myself or anything, but this is a gross over-simplification of the findings. Even if it weren't, I'm not sure how I feel about the ethics involved in using science to people's (women's!) detriment in this way.

Women, as the marketer noted, feel guilty about a lot. One of the things the culture teaches us is to look at what we eat as a moral issue. There are "good" foods and "bad"; on a given day, depending on what we've eaten, we've been "good" or "bad." Some foods are downright "sinful"! When we're not blowing them, we follow our diets "religiously." We see our self-control as a matter of character, of will. So Frito-Lay set out to reframe junk food so as not to "trip [our] guilt."

Part of the strategy was . . . toning down the packaging and showing off healthy ingredients in the snacks.

“She wants a reminder that she’s eating something better for her,” [Marketer] said.

Even thought she isn't.

Baked Lay’s will no longer be in a shiny yellow bag, but in a matte beige bag that displays pictures of the ingredients like spices or ranch dressing. Some of the new Frito-Lay packaging is in stores already.

. . . the packages trumpet characteristics like fiber and calcium and show ingredients like wheat or almonds.

Now that's cynical.

Amazingly, given that we supposedly can handle more complex material, they have developed an ad campaign that involves a bunch of female air-heads kvetching about their diets, their men, and so forth in nasal tones at the upper end of the register. I, for one, find these "characters" hard to identify with. And to add to the irony, the Marketer muses that it's obvious that we are offended by pink packages or prominently featuring the calorie counts: She completely misses how insulted we would be by an attempt to get us to eat crap by giving us a bunch of pornulated airheads to "identify with."

A sample of the print version of the ad follows:

. . . two women are surveying a Baked Lay’s bag. “These things are the best invention since the push-up bra,” one woman says. The other, admiring her bra-enhanced chest, responds, “I wouldn’t go that far.”

Now that's insulting!

And that's it for me and Frito-Lay. We're done.

Blind Obedience

or, Some Things Never Change

Umpty-ump years ago, Stanley Milgram, a Jewish psychologist interested in better understanding the Holocaust, began a series of experiments to see just how far ordinary citizens would go in obeying orders to harm another person. In the best-known of these demonstrations, 65% of his study subjects shocked (as far as they knew) another human being clear into unconsciousness and (for all they knew) possibly even death. This, even in a situation in which it was perfectly safe to tell the authority figure where to stuff it. As one of my students put it the other day, "People are sheep."

However, as Miller (2009) notes, over the entire series of experiments (there were 16 in all), 60% of Milgram's 540 subjects disobeyed orders at some point. So not all people are sheep, and some are sheep only up to a point.

Reasons (some) people are sheep (up to a point) include that, in our culture at least, we are socialized to obey authority. Children who mind well are valued, whereas those who don't are punished or taken to therapy or both. We even have a diagnostic code for particularly willful little brats: We label it a mental illness, Oppositional Defiant Disorder. I would also submit that the child who obeys is the child who survives to maturity and reproduces. Children who play with fire, run with scissors, and dart out into traffic do not. It's that simple.

We don't, of course, raise our children to be cruel. This underscores Milgram's point, which was that it is really the situation which is the most powerful factor in producing destructive obedience, not our national character or our individual personalities (Blass, 2009). This also explains why people, you and me included, will predict based on self-knowledge that they would never do something like this, and then most will, if conditions are right. You and I might, too. The trouble is that we don't know as much as we might about what situational variables have what effects. In any event, we can't control situations. We can, at least potentially, control our reactions. But to do that, we need to know more. We need to know what characterological traits enable us to prevail over even the most powerful situations. But let's get back to the list of reasons why we act like sheep sometimes.

Sheep-ish behavior can be induced by degrees. In the Milgram studies, as is often the case in real life, people eased into bad behavior--in this case, 15 volts at a time. What's 45v when you've just administered 30? ...165 when you've just administered 150? Hitler didn't start out saying, "You're gonna personally slaughter 6 million Jews and several millions more gays, gypsies and people with disabilities." No. He started out just talking bad about them, which got people ready to make them wear the Star of David or a pink triangle or whatever on their sleeves, then he took away some relatively minor civil rights, working his way up to Kristallnacht and such. He crept up on rounding them up and killing them, one small step at a time. And the sheep--whoops! I mean, people--went along with him. Not everybody, of course, but enough so that he could get the job done.

Sales people are trained in a similar technique: Get the consumer to say "yes" to as many questions as you can ("wouldn't you prefer a car that is reliable? beautiful? American-made?" Well, of course) before you spring the ultimate question ("Will you buy this car?") on him and he will say "yes." It's a tried-and-true technique. Milgram got people to say "yes" to 15v and worked them up 15v at a time until they were administering potentially lethal shocks using this method. Hitler got people to say "yes" to talking ugly about Jewish moneylenders and worked his way up to "yes" to the cold-blooded slaughter of unarmed women, innocent children, and helpless cripples. It was easy. And it only took a few years to talk a couple of million people into this madness.

Which brings us to #3. We tend to do what the rest of the flock group is doing. It's called group think and many, many studies have documented just how distorted (and extreme) our thinking can get when the group not only doesn't offer a corrective point of view but is actually leading us to the fringe. Fourth, when somebody is telling you to do something, you can slough off responsibility. "I was only following orders" echoes down through history as justification for all kinds of moral failings, ethical violations, and crimes against humanity, from Andersonville to Abu Ghraib. "Baaaa," quoth my student. The sheep will follow the goat.

Most interesting, however, is the sloughing off of responsibility onto the victim. Milgram found that subjects who obeyed ascribed twice as much of the responsibility for what happened to the victim, compared to subjects who resisted (Blass, 2009). Milgram thus may have been the first scientist to document the blame-the-victim phenomenon which Hitler so ably exploited in turning his countrymen against the Jews.

In Jerry M. Burger's (2009) replication of the Milgram studies, which just landed in my mail box last week, one variation in the experimental condition was to have a confederate model noncompliance. This had nearly zero effect on rates of obedience among experimental subjects. However, when two confederates modeled noncompliance in the original Milgram studies, experimental subjects also refused requests to shock their victims any further. It seems that if there is a group of people doing the right thing, it becomes easier for us to resist malignant authority--it gives another, perhaps more palatable, group to join. We don't have to give up the safety of the group in order to follow our conscience: The new group presumably offers us more or less the same benefits as the old one.

Unfortunately, in the real world, there may be no effective individual models for resistance, never mind groups. Evil organizations tend to screen those folks out where they don't self-eliminate, so that for the individual at a moral or ethical decision-point the only available behavioral models may all be torturers and murderers who furthermore are skilled at socializing the novice into the group pathology. An example would be a corporation headed by a sociopath. He (and the stats are that it usually is a "he," guys, so don't get your dander up) will intuitively, if not consciously and deliberately, hire like-minded folk. Who will in turn hire more of the same to work in various corporate departments and branch offices. The occasional non-psychopath who accidentally gets hired will either leave on her/his own, get co-opted (i.e., turned into a sociopath), or be run out of the company. Or sit silently by while evil is done (Miller, 2009). So what you will wind up with over any extended period of time is a company full of sociopaths. But I digress.

Evolutionary psychologists would say that we are hard-wired to feel, think, and behave as a tribe, and it has obvious short- and long-term survival value for us to do so. Think about it: There's not much with a lower potential for long-term survival and reproduction than a single hominid alone on the vast African savannas, is there? Indeed, a half a million or so years later, among certain Plains Indians the most severe punishment available was to run an individual out of the tribe--an almost certain death sentence. And of course even today in dangerous professions such as police work or military service, "going along to get along" has immediate survival value. You have to be able to count on your comrades having your back (see Benjamin and Simpson, 2009, for further discussion).

Stage hypnotists know that the very fact of a subject's volunteering, the parameters of which act are defined by the way the invitation is framed and delivered, guarantees better (e.g., more easily hypnotizable or compliant) sheep--dang! I did it again--subjects for the show than if one picks them out of the audience oneself. Similarly, rates of obedience in an experiment or an SS unit may be higher than they would be in the population at large. Miller (2009) also makes this point.

Given all this, the wonder is that 35-60% of Milgram's subjects stopped when they did. Indeed, as Lee Ross (1998; cited in Benjamin & Simpson, 2009) wrote, "The Milgram experiments ultimately may have less to say about 'destructive obedience' than about ineffectual and indecisive disobedience" (p. 16).

Of course in Milgram's studies, nobody was really getting shocked, therefore, presumably, no one was harmed. Still, there were ethical concerns: It was pretty stressful for the study's participants, and we just don't do that any more. Consequently, in order to "replicate" the study, one would have to change the procedures pretty drastically.

Burger (2009) has done just that. His study stopped after participants thought they had delivered 150 volts to the confederates, whereas Milgram's study went to 450v. Burger selected this stop point because in Milgram's lab, most people who quit stopped there, while most people who crossed that line continued to the bitter end. Burger also screened out people (the depressed, the anxious, the traumatized) who might be harmed in the study. Alan Elms, who assisted in the original study, calls this "obedience lite" (2009, p. 33), more about which, later.

The question was, has anything changed? Are we more aware of the danger of blind obedience than we were 50 years ago? Would it make any difference if we studied women, too? Burger found that (1) no, it hasn't, (2) no, we apparently aren't, and (3) no, it doesn't. The latter probably will not surprise students of the Holocaust, who know that some of the most notorious concentration camp overseers were women SS. And some of you may recall that the poster child for Abu Ghraib was a girl.

Jean Twenge writes that, according to her research, young people today should definitely be far more likely to defy authority than a bunch of middle-aged white guys would have been in Milgram's day. She interprets Burger's data as showing a trend, albeit nonsignificant, in the direction of increased resistance to authority, and she points out several aspects of Burger's study which may have inadvertently suppressed further evidence of change (Twenge, 2009). Unfortunately for her argument, Blass, (1999, 2004; cited in Blass, 2009) did a meta-analysis of 25 years' worth of studies and found a "near zero" (p. 43) correlation between the time the study was conducted and the obedience rate.

Also, Twenge's analysis relies heavily on the sampling differences, and for Burger to use a sample more like Milgram's would have, in my opinion, rendered it ecologically invalid. We want to know what college-educated, ethnically diverse, gender-inclusive police and army units would do in the face of an illegal order. We want to know what a melting-pot populace like ours, asked to go along with a Guantanamo or a Patriot Act, would do. With the possible exception of corporate boards, exclusively white male groups like Milgram's study sample are, after all, scarce on the ground any more.

Twenge (2009) also argues that Burger's study confounds obedience with violence and lack of empathy. She notes that the increase in narcissism over the intervening generations since Milgram's day and the desensitization to violence from tv and video games may account for part of the "obedience" rate Burger found. The empathy argument won't wash, however, as Burger tested for empathy (and consequently, indirectly, for narcissism) in his subjects and found this trait not predictive of compliance/noncompliance. As for the violence argument, this is splitting some exceedingly fine semantic hairs. Who cares what we call it? The end result is the same. People will still hurt other people when told to and/or given the opportunity to do so. Baaaa. I am sure that from Andersonville to Auschwitz to Abu Ghraib, plenty of narcissists and violent people took full advantage of the opportunity to act out, side by side with sheep-ish folk who were merely "following orders."

A stronger argument is probably that of Elms (2009), who pointed out that by stopping the study at 150v, Burger effectively eliminated the most critical aspect of the original. And as a result, Elms argues, we cannot say whether people would still hurt, injure, and possibly even kill each other under orders. Maybe if the victims were still writhing, screaming, and finally falling silent, the increased independence that Twenge has documented in her work would have asserted itself and Burger's rates of disobedience would have been much higher. Or not: Burger's subjects were still arguably well within their comfort limits, but on the other hand, discomfort didn't seem to slow down many of Milgram's. We may never know, because the likelihood of getting such a study past an IRB these days is just slightly less than nil.

Elms and Twenge both express concerns that screening out people who would be "upset" by the study reduced disobedience. But that dog won't hunt, either. I would argue (again) that first, being upset did not appreciably contribute to disobedience in Milgram's original studies: In fact, one of the most notable findings was the degree to which people could be upset and still continue on with the experiment. Second, police and military organizations take great care to screen out the anxious, the depressed, the previously traumatized. If we want ecological validity in a study predicting what a soldier might do in, say, a My Lai-type situation, then we need to screen out the folk who wouldn't likely make it into an overseas combat unit in the first place. Works for me.

So while the "lite" factor is a big problem, I don't buy the other criticisms. From my point of view, the biggest disappointment is that we didn't learn something more about, to paraphrase Ross, effective, decisive resistance. Elms (1972; Elms & Milgram, 1966; as cited in Elms, 1990) conducted extensive psychological testing on subjects from Milgram's series who had obeyed or not obeyed, in an attempt to discover some differences. He found only nonsignificant correlations between obedience and authoritarianism.

As noted earlier, Burger had thought that maybe the degree of empathy a person generally has for others might make a difference, or the degree to which control was important to them, but neither personality trait proved to be a predictor. Neither were such demographic factors as gender, age, or level of education. The different ethnic groups weren't big enough, statistically speaking, to test.

So we still don't know why approximately 1/3 to 2/3 of people will refuse to obey an illegal order. To me, that would be the most useful information of all, and I hope somebody, somewhere, is working on that. Burger's was an elegant piece of work, and one can only hope that there will be lots of replications with variations intended to tease out what it is that allows some people to "just say 'no'" to human cruelty.

References

Benjamin, L. T., Jr., & Simpson, J. A. (2009). The power of the situation: The impact of Milgram's obedience studies on personality and social psychology. American Psychologist, 64, 12-19.

Blass, T. (2009). From New Haven to Santa Clara: A historical perspective on the Milgram obedience experiments. American Psychologist, 64, 37-45.

Burger, J. M. (2009). Replicating Milgram: Would people still obey today? American Psychologist, 64, 1-11.

Elms, A. C. (2009). Obedience lite. American Psychologist, 64, 32-36.

Miller, A. G. (2009). Reflections on "Replicating Milgram" (Burger, 2009). American Psychologist, 64, 20-27.

Twenge, J. M. (2009). Change over time in obedience: The jury's still out, but it might be decreasing. American Psychologist, 64, 28-31.

So Whudja Think?

I'm loving the discussions on discussions in the blogosphere of late. Sisyphus (who is actually a cat, but never mind) over at Academic Cog started it. When you get done with that, read Dr. Crazy's response at Reassigned Time.

I am not nearly as intellectual as either of these ladies, so my classroom discussions tend to begin with, "So whudja think?" But like Crazy said in her comment,

"I definitely have an agenda for what I want them to get from the texts that I assign, but I think that the best discussions happen when I'm not terribly controlling in my methods for getting students there."

Before we go anywhere else, I want to find out where the class is at with the assigned reading. Sometimes they have a better idea than I did about where to go with it. Sometimes I find out up front that they didn't even get it, so some explaining is in order before we try to discuss. But I always start with their initial, gut reactions to the thing.

We have to get past that, though. I want them to do in class (and in their reaction papers) more. In ethics, there are, obviously, some clear Rights and Wrongs. You don't have sex with a client. That would be a clear Wrong. But some things are fuzzy, and some things in the ethical code conflict. And some things haven't been sorted out by the experts yet. For example, some say we should never mix the therapeutic and forensic roles. Others say that separation is neither possible nor practical. So how do we as practitioners handle that? I want them to be able to cite cases from licensing board and ethics committee proceedings, the Code itself, and case law to support their arguments. I want them to be able to cite commentators' opinions and research findings when they are available. And finally, I want them to be able to consult with colleagues and document their ultimate decisions as to a course of action.

But Sisyphus complains that "the refusal or just plain inability to dig your fingers into the guts of the text and mush things around is prevalent in my class right now,"and there is some of that in my class as well. Indeed, my students occasionally express frustration that the Code and its commentators don't just tell them what to do! They even accuse people who grapple with ethical issues of the sin of ethical relativism, apparently on the theory that "everybody" already "knows" (or should know) Right from Wrong. I want these folk to come to understand, over the course of the semester, that part of what makes psychology a profession (as opposed to a technical field) is that there isn't just a manual that you can follow, that the work requires sometimes difficult judgments.

I came to teaching in general (and to discussion in particular) with more clinical than academic experience. As I have noted previously, the Georgia School of Professional Psychology was oriented toward clinical practice, not research and teaching. So I never had the opportunity to TA with the professor I most admired, and we had no undergraduate program to practice on either. What I did know how to do was group therapy, and I brought some of those skills (e.g., getting people to talk to each other, not the group leader) to the classroom. And that did give me a good start. It feels natural to me: I don't agonize over it they way I do over my lectures in my Personality classes. (I've never given birth to an infant, but I imagine the process is somewhat similar.)

Classrooms are also similar to groups in that, while you want members of each to be talking to each other more than they do to you, you also must still remain in charge. You have to keep people on task. You can't let someone become a scapegoat for the rest of the group. And as Crazy noted, you can't be afraid of silence. Group therapy is not performance art: Members can't come to group expecting you to 'do them some therapy.' They have to bring something to the table. It is similar with students, at least in ethics class: You can't just lecture people on ethics. That's not how people learn to be ethical. They have to engage with the issues. So if they aren't, you can't be afraid to just sit there until somebody pipes up. I learned a long time ago as a group therapist that nobody can stand it longer than one minute: Try it yourself. Count off 60 seconds in your head next time you find yourself doing all the work and see if somebody doesn't start something before you make it to 60. Works every time.

What I'm still learning is how to be "explicit about how what we do in class... connects to what they do when they read, what I expect of them on writing assignments, and what they do on tests." My Personality classes have been totally at sea on how to use empirical articles to examine a public figure's personality, and my Ethics students tend to write reaction papers that are just that: their reactions. No processing at all.

Crazy's post made me see the obvious: That not only have I got to do this 'make explicit' thing more than I have been in class discussion, but also in instructions for assignments, study guides, and even in my lectures. For next semester's Personality class, I'd already picked one public person (just like they will use for their case study/term paper) to follow all the way through the course, using research and theory to explain her as well as using her to demonstrate theory and research. Before, my choice of examples from one class session to the next was pretty random, and they haven't been 'getting' how to do their papers because of it. Now in addition to using a better class of example, I know I have to lay out for them how to use that example.

Courtroom Antics

I have two cases going to court in the next couple of weeks, one civil and one criminal. And it's got me to thinking about past forays into the justice system and how weird it can get.

Used to be, we were the only private practice up here for miles around, and we had folks drive from as far north as Dalton and Copper Hill for therapy. As a result, we were occasionally in courtrooms just about anywhere in the Blue Ridge circuit. Judges and attorneys varied wildly in quality. On one memorable occasion, I drove all the way up to Calhoun to testify in a divorce case in which I had already warned both parties that I had nothing to say that would be good for either of them. But one of them subpoenaed me anyway, so off I went at the crack of dawn to the wilds of north Georgia. No sooner had I been sworn in than the judge asked me if I wanted to waive privilege. I said "No," he excused me, and that was that.

Now I am no lawyer, but it is my understanding that, in the first place, the privilege is not mine to waive. It is the client's, and the soon-to-be-ex-wife, by subpoenaing me, had already waived hers. (Not to mention that, under Georgia law at the time, communications with me weren't privileged in the first place.) But whatever. I didn't want to be there so this suited me just fine.

Even some counties close in to Atlanta were pretty back-country when I started my practice. I was in Dallas one day for a child sexual abuse case. This Court liked to assemble all the parties, including witnesses, before beginning trial and was calling roll. The child victim was female, and was accompanied by her mother. The mother had brought her divorce attorney, who was female, as there was also a modification of custody action pending. I'm a woman, of course, as was the pediatrician who was going to testify to some physical evidence. A female police officer was there to testify as well. At about this point in his roll call, the judge, clearly exasperated, turned to the (female) ADA and asked, "Is everybody in this case female?" to which the ADA, straight-faced, replied, "No, Your Honor, the Defendant is a man." The courtroom broke up. Even the bailiff was laughing.

Holy Mackerel, George (Bush)! What Were You Thinking??

I see that our government, and some of my fellow psychologists, have (once again) been up to no good.

For evidence, I offer MALINTENT, Homeland Security's cool new airport screening device. Short version, it uses "research on human behavior and psychophysiology" to detect bad guys. Read about it here, then tell me it doesn't leave you speechless, too.

"Yikes" is all I could think of to say.

By Monday, when we discuss the ethics of the pilot study in my Theories of Personality class, perhaps I will have found my tongue.

Parcoblatta virginica

It never ceases to amaze me how long it takes psychology as a profession to get something into print. For example, it can take up to two years to get an obituary into the American Psychologist! Mail announcements from my state organization are frequently delivered days, if not weeks, after an event. Last year's Annual Report only just arrived from the national organization, in the July/August 2008 edition of the American Psychologist. Wall Street would have a cow if any publicly-held corporation took that long to get its profit statements out.

The Report rarely makes for interesting reading. There's lots of drek in there, like pages and pages of teeny-weeny type reporting who joined last year: Who cares? and pages of committee reports. This year, however, I am happy to be able to say that the issue contains a restatement of our opposition to torture. (Did you really think that we could come out in favor of it?)

We're also for health care reform and we adopted the Guidelines for Psychological Practice with Girls and Women as official policy. We also adopted as policy the Record Keeping Guidelines. Most amusing, we have officially rejected Intelligent Design: As a scientific organization, we should never have had to discuss any other option, but there it is.

I do always like to read the Report of the Ethics Committee, however, because this always includes the number and kinds of complaints that were filed in the previous year. I confess to a certain amount of morbid fascination with this data. In addition, this year I plan to use it to focus my efforts in my ethics class. For example, among the winning student papers on ethics last year was one entitled "MySpace or Yours? The Ethical Dilemma of Graduate Students' Personal Lives on the Internet," to be published in Ethics & Behavior this year. This strikes me as a perfect topic for an in-class discussion.

Apropos of the above, I Googled myself to see what personal, embarrassing, unprofessional stuff might be 'out there' about me... and discovered the Virginia wood cockroach (Parcoblatta virginica), a portrait of whom I have included above for your enjoyment. This particular one was once a denizen of Fort Sill, Oklahoma. I've never met her.

Teaching

It's a sunny Saturday afternoon. There's just a few cirrus clouds floating high in the sky but I'm inside because of the bumper crop of mosquitoes produced by last week's rains.

I am alternately doing laundry and prepping for class. That's right: In a few weeks I will be back in the classroom, teaching ethics and theories of personality to undergraduates.

It's exciting. I love psychology, and I love teaching. It's fun reading the texts, tweaking my lecture notes, thinking about how I will present information and challenge students to dig into the material, integrate it, use it.

But last semester, my first time back teaching in over a decade, I found that even upperclassmen and women here are not doing college-level work, particularly when it comes to writing papers. My excitement is tempered somewhat by the need to figure out ways I can challenge the good students without leaving the majority floundering.

Some of my colleagues seem to be dealing with this problem by "dumbing it down" to the lowest common denominator. I have seen one syllabus for the personality course which has two single-spaced pages on how not to commit plagiarism. Others have students turn in papers at each stage of the writing process, from topic selection to final draft. We did that back in Mrs. Touchstone's 7th grade English class.

I am not willing to teach a middle-school-level class on how to write an essay. In the first place, I signed on here to teach college, not 7th grade. In the second place, some of these students will be starting work on their doctorates within a year: In my opinion, it's far too late to be cramming remedial English.

But what's the alternative? Wash them out? At this late date? It seems to me that the time for either remedial work or a washout is in their freshman year, not now when they are only months from graduating.

On the other hand, I once worked with a psychologist whose assessment reports were completely incomprehensible. I never received one that I didn't have to walk down the hall and around the corner to ask her to explain. And that's exactly how she got there, I'm convinced: Because her professors kept passing her along even when she couldn't do the work. What's worse, to get a license in this state you have to turn in a work sample: Which begs the question, did somebody else write up the case for her, or did the licensing board give her a social promotion too?

Somebody's got to be the one to say, hey, this kid can't cut the mustard.

I haven't had too much trouble with outright cheating, but I am mindful that it does occur--probably has in one of my courses and I just haven't caught it. Let me just say here that I find it especially mind-bending to be thinking how to prevent students from cheating, or how to catch them if they do, in an ethics class, for heaven's sake. I thought assigning lots of little reaction papers might do the trick, until I found websites offering reaction papers for sale. Is there no end to my naivete?

I knew you could buy a term paper, of course, but I have to admit that I really was flabbergasted to find that students would pay for a two-page essay. What am I supposed to do, "test" them during discussions to see if they've at least read, if not written, their own papers? I didn't sign up here to be a cop. That's what Teaching Assistants are for. I only wish we had a graduate department I could get one from!