first post in many months...

I was reminded today of the complications of the human brain.  It is an ongoing question at the basis of most psychology: how much of our behaviour are we born with and how much does our environment create?  even at the level of a single person (perhaps especially so) trying to detangle the influences are challenging indeed.

I have a lovely young man  who was referred some years ago for treatment following a psychosis.  The episode was very violent and paranoid.  He has only partially recovered. He is still very odd, with flattened affect, very unusual and paranoid eye contact, very problematic relationships and absolutely no tolerance for stress.

What is most interesting, at least to me, is the question of the cause of both his psychosis and his residual oddness. His story of marijuana use is extreme. He began smoking pot regularly at ten years old. (!!!!!)  He was raising himself at the time because his single mum worked full time and he was alone for at least two hours every afternoon. He struggled at school and probably had some learning problems. He was odd before the pot smoking and became much odder. He then developed psychosis.

So we have a combination of learning problems, poor parenting, limited supervision, poor social skills, intense marijuana use very early and for a lot of years. He may have also had a genetic predisposition to psychosis.  The consequences have been catastrophic for my client and teasing out the causality almost impossible.  

More ...

One part of my job as a clinical/forensic psych' is to write reports for people who have lodged a claim with the Victim's Compensation Tribunal. This is a scheme designed to compensate people who have been the victims of serious violence. My job is to assess if victims of violence have suffered a psychological injury from the violence.  I interview people, read documents they bring along and sometimes talk with people who know them well. The idea is that I need to compare how they were travelling before the violence and compare that to how they are travelling now. The difference in functioning is a result (presumably) of the violence.

What many folk don't really understand is how these assessments are made. Many come along to talk to me without any idea of why they are there or what to expect. Many don't want to tell the story again but know that it is part of the process of being a victim of crime. These people often become very angry indeed when they don't walk out of my office with lots of money.

I feel that i am held responsible for the compensation they receive, even when i don't make the rules or even make the determination. I just do an assessment.

Though it time to clarify a few things about the VCT process. I have to look for *an injury,* a specific psychological disorder. The assessments are not about how terrible the offender was, or how bad the police were. The assessment very clearly rests on what the injury was and how bad the injury is.  Some people have a terrible thing happen but are not injured.  These people walk away with few lasting problems. These people are not entitled to compensation. Because it is about the resulting injury not the terribleness of the assault. 

Alternatively, some people cant or don't tell me anything. They run out of the room, they don't show up in the first place. Some people don't bring along any helpful documents such as school reports and some people refuse to talk. Obviously these people don't end up with a very big compensation. I can only write what i know. I cant make it up. I cant just guess.

Another possibility is that people don't get a big compensation because they really were not terribly injured.  For some people they feel that they deserve money even when they are still at work, still going out on weekends and still being adequate parents. They don't realise that they sit in the very mild end of affected by violence. The people who receive large amounts of money are more likely to be affected in most areas of their lives: they cant work, parent or have any social contact.  Some people will spend the rest of their likes being intermittently admitted to hospital, being drug addicted, struggling with suicidality. That is the severe end of the spectrum and the people who receive significant sums of money. Often there is no way for people to understand that they are affected by a crime but are still doing pretty well.  They also don't know that they in the end will be much better off not receiving a pretty paltry 40 thousand but be disabled for life.

More ...

Recently I've been observing a trend in victims of crime and their history.  Have I made this observation before? possibly. It is one that keeps occurring. 

So here is the crime: A young woman about fourteen to sixteen who is gang raped.  She has been raped by young men who are known to her boyfriend and he is there when it happens. So how does this happen and why?

So that back ground is that she has been taking drugs a lot. She hasn't got great friends and those she has take drugs too. The boyfriend in particular takes lot of drugs and hangs out with pretty unpleasant types. In fact he might be sailing pretty close to the wind in terms of criminality.  What seems to have happened is that she is offered up for drugs. She is forced to "pay" for the drugs that he or she or they have taken.

She struggled with school and nobody seemed to notice. She was bewildered by the change to highschool and slipped out of school before anyone could notice. She spent time with those people because she was socially awkward and hung out with anyone who'd have her. She didn't fight them or leave them or struggle against them because she felt she had no choice. She was in situations that left her unable to physically defend herself because of drugs and booze. Take anything, do anything. Just go along with it. 

Amazingly she often leaves the site of the abuse with the boyfriend and stays with him at least for a time.  Needless to say the outcome is catastrophic.

More ...

i am not often reduced to hopeless tears in session. partly because i am an old bag who has done this job for a bit to long and partly because crying uncontrollably is kind of against the code of being "a professional." Anyway today was the first day for a long time that I lost it in session.

So today I cried buckets for a lovely boy, well a young man, who finally came out to his Dad. He has struggled with massive anxiety and social phobia for years, partly as a consequence of intense bullying by his peers for his differentness. It is also partly a consequence of dad giving him "i hate poofta" messages all his life. We all the know the moments: when dad laughs at the TV or scoffs at a gay character. Or when he comments on the disgustingness of homosexual relationships.  But today he decided that he had had enough of secrecy and insincerity. Today he needed to finally tell his father the truth.

He summonsed both his mother and father to a session in my office. I had both the privilege and stress of sitting with this family while my client finally told the truth. He wrote a beautiful anguished and torturous poem. In it he explained how he had felt so alienated, so tortured, and damaged he, at times, didn't want to keep living. He read the poem out loud. He told his father clearly that he was held partially responsible for the righteousness and judgement. His father cried and he cried and I cried buckets.  His father responded as my client would never have imagined. He told him he didn't care about sexuality he just loved him more than anything in the world.  His father was so very very sorry that he was the source of so much sadness for his son.

We spoke about his father needing to "own" that he is the father of a gay man and out himself to friends and family. I proposed that my clients sexuality is something to celebrate not just to tolerate. A step to far perhaps, but a goal worth identifying.

As I have said in a previous post, this is only the beginning of a process of healing but at least it is a beginning. More ...