of all people…

Posted on Friday 7 March 2014

If you’re a psychotherapist and nobody teaches you this, your patients will make sure you know it. The 12 Step Recovery programs even have it as part of one of their Steps, "… and when we were wrong, promptly admitted it." People in psychotherapy, by definition, have to learn that they’re wrong about a lot of things, and that’s a painful thing to learn even if it helps in the long run. So when the therapist is wrong about something, it’s their turn to get even and they will stick to your errors like super-glue. It’s only fair. So you quickly learn that when someone says you’re wrong – think long and hard about it; don’t get defensive; and admit it out loud if they’re right [or lose a patient’s trust]. Actually, finding out that your therapist can admit to errors actually builds trust. It models something healthy [and levels the playing field]. Back in the day when we psychiatrists were all therapists, mid-level psychiatry residents had been so humbled by being repeatedly confronted by their patients that they would admit to anything, so we had to reteach them how to be right [when they were]. My point is that I’m used to people in mental health being willing to admit being wrong. And the story I’ve followed in these posts is partially about that very topic, owning up to wrongness [see When Psychiatry Battled the Devil]:

  1. the unforgotten unremembered… [01/06/2014]
  2. the twilight zone… [01/09/2014]
  3. learning from mistakes… [01/28/2014]
  4. perhaps bigger… [02/17/2014]
And I’m not the only person who has followed the back·and·forth·ness of this peculiar story:

The details are cataloged in the posts. Briefly, Richard Noll wrote an article about the crazy episode from the late 1980s to the mid 1990s when patients and children reported something called Satanic Ritualized Abuse, and many therapists caught the bug and began treatment based on the stories. Parents accused Day Care Centers of these activities and some Day Care workers went to prison. Journals appeared, Organizations pro and con appeared, conferences and workshops were held, diagnoses were created [MPD, DID] and added to the DSM-IIIR, and the news media couldn’t get enough of it. And then it was gone. At the time all this happened, Richard Noll was a young psychologist who spoke out against it as mass hysteria.

So now, twenty years later, Richard wrote an article about it, noting that we have all forgotten that it even happened, and suggested that since 20 years have passed, maybe we could take a look at back then. He submitted it to Psychiatric Times, and they eagerly accepted it. It was published on-line on December 6, 2014, but a week later, it disappeared. When Richard inquired why, it seemed that one of the psychiatrists had objected and apparently threatened litigation. After that, Psychiatric Times was going to publish it, then they weren’t, then they were, now it’s in maybe·limbo. I’ve lost track of how many times they’ve waffled back and forth.

And now for a new wrinkle in this already rumpled story. The editor of Psychiatric Times is Dr. James Knoll who has been behind all the back·and·forth·ness. It seems that he’s a Forensic Psychiatrist, so it’s not surprising that he might be hypersensitive to the threat of suit. I say "hypersensitive" because the article itself is pretty straightforward and factual, hardly an indictment of anyone. While it’s easy to see that the people involved back then might be embarrassed, it really did happen. And about that new wrinkle, Dr. Knoll himself has had some things to say about evil.
by James L. Knoll, IV, MD
The Journal of the American Academy of Psychiatry and the Law. 2008 36:105–16.

The author notes an increased interest in the concept of “evil” in the fields of psychiatry and psychology. In particular, there is some interest in defining and testifying about evil. It is argued that evil can never be scientifically defined because it is an illusory moral concept, it does not exist in nature, and its origins and connotations are inextricably linked to religion and mythology. Any attempt to study violent or deviant behavior under the rubric of this term will be fraught with bias and moralistic judgments. Embracing the term “evil” into the lexicon and practice of psychiatry will contribute to the stigmatization of mental illness, diminish the credibility of forensic psychiatry, and corrupt forensic treatment efforts.
This is a pretty interesting article in its own right. Here’s a sampler, but the whole thing is posted online.
An ancient reaction to fear, distress, and calamity has been to rely on religion. “When cause and cure are unknown, magic and religion supply welcome hope”. In biblical times, mental illness was seen as the opposite of what was “good.” During the Middle Ages, most progress in medical science was severely squelched. The Christian church, consumed with superstition and demonic possession, rode herd on the diagnosis and treatment of mental illness. During the Renaissance, an obsession with evil in the form of witches became prominent. The official practice guidelines on detecting witches, the Malleus Maleficarum [1486], assisted inquisitors in finding evil lurking amid women, the socially disenfranchised, and the mentally ill.

The witch-hunting of the 15th and 16th centuries serves as a fascinating and sobering example of an official recognition of a hitherto unknown form of deviance.14 Once the crime of witchcraft was officially recognized, serious problems developed in providing “proof ” and legal restraints to the hysteria. The powerful legal and religious emphasis on the reality of witchcraft helped to reinforce the legitimacy of the trials, in addition to the public’s belief that there was evil afoot. It has been theorized that the English government’s systematic efforts for dealing with witchcraft served as a form of repressive deviance management. In addition, one of the benefits to church and state of the witch-hunting hysteria was that it effectively shifted public attention away from growing demands for more equitable redistribution of wealth.

In retrospect, evil (in the form of witches) was nothing more than what the English legal system claimed that it was. Those who were found to be witches were often ill equipped and powerless to fend off this creative label of deviance. Once the definition of witchcraft was officially accepted, very little could be done to prevent or limit the system’s abuse of the term. As a result, large populations of “deviant” witches were discovered, particularly among vulnerable lower-class groups, which, in turn, fostered the growth of an “industry” revolving around the detection, prosecution, and punishment of witches. The industry included the proliferation of “rackets,” and entrepreneurs seeking to profit from its operation…
Dr. Knoll goes on to conclude:
Evil can never be scientifically defined because it is an illusory moral concept, it does not exist in nature, and its origins and connotations are inextricably linked to religion and mythology. The term evil is very unlikely to escape religious and unscientific biases that reach back over the millennia. Any attempt to study violent or deviant behavior under this rubric will be fraught with bias and moralistic judgments. Embracing the term evil as though it were a legitimate scientific concept will contribute to the stigma of mental illness, diminish the credibility of forensic psychiatry, and corrupt forensic treatment efforts…
You might ask, "Why was Dr. Knoll writing about this topic in the first place?" Well, he was debating Dr. Michael Welner, another Forensic Psychiatrist who holds the opposite view and describes a Depravity Scale to measure evil. Here’s Welner’s response:
by Michael Welner, MD
The Journal of the American Academy of Psychiatry and the Law. 2009 37:442–9.

Forensic science research intended to standardize the distinction of the worst criminal behavior, specifically the Depravity Scale, has been the topic of academic and public discussion in the Journal and elsewhere. Some early impressions have been published without substantive attention to the goals of this research and the application of the results. In a recent article in the Journal, for example, James Knoll argued, “Evil can never be scientifically defined because it is an illusory moral concept,” adding, “it does not exist in nature”.

It is my contention that evil does exist in nature. In fact, evil exists in the very law with which advanced societies judge the actions of man. In the United States, different state and federal sentencing guidelines distinguish among heinous, atrocious, cruel, vile, horribly inhuman, and, yes, evil criminal behavior. Such designations elevate culpability in a variety of offenses, ranging from murder to burglary,  and affect parole eligibility in states as diverse as California and Louisiana…
And, by the way, neither of these articles mentions the Satanic Ritualized Abuse episode Richard Noll is writing about our forgetting. So reading Dr. Knoll’s paper, we might see why he was enthusiastic in accepting it to Psychiatric Times. However, he’s probably more aware than most that this is the stuff of emotional ambivalence and conflict within us all. Dr. Knoll ends with:
To be clear, I am not here condemning philosophical investigation into the problem of evil. Rather, it is the search for it through a scientific lens that I caution against. As regards the philosophical route for studying evil, we might keep in mind that “the honest course is always to begin at home”. Surely, this is the more difficult, yet profitable course. Tracking down the roots of evil is a process that requires delving inward in an attempt to discern what we don’t know about ourselves, yet do to the other. In closing with this point, perhaps it is fitting to quote a piece of poetry popular in our age:
    I shouted out,
    “Who killed the Kennedy’s?”
    When after all,
    It was you and me.
As much as I’m tempted to wax eloquent about the universality of a spirituality of good and evil in the mental life of children, and it’s persistence in the adult psyche, transcending the rational adult thinking at times, you can likely do that for yourself as Dr. Knoll suggests. More important to the matter at hand, "Who was wrong?" The patients and children who reported these conjured up evil acts were wrong. The therapists, parents, and legal officials who wrongly punished [and are still punishing] innocent people were wrong. Those of us who read these stories in the paper and didn’t take to the streets were wrong. And Dr. Knoll was wrong for pulling this article without even speaking to Richard Noll just because somebody got their feathers ruffled. And he was wrong for not giving Dr. Noll a place to remind us of the importance of not sweeping the concept of evil under the bed or hiding it in a dark closet. In this case, that’s what we’ve actually done [like the children we once were]. The Journal of the American Academy of Psychiatry and the Law published Dr. Knoll’s musings about the same topic. Dr. Noll’s article is a companion piece with a very real compendium of case reports – an important reminder of what can happen when evil is actually instantiated and prosecuted. As an Editor and as a thoughtful Forensic expert, he of all people, is wrong not to afford Dr. Noll the same forum he was given himsef…
  1.  
    berit bryn jensen
    March 8, 2014 | 3:23 AM
     

    The Women and the Generals, a documentary about the Indonesian genocide 1965 – 1968, was aired on television last evening after How we kill, the recently Oscar-nominated documentary. The military strongman Suekarno made his way to the political top by exploiting fear and superstion. Women activists associated with the Indonisian Communist party were accused of murdering and mutilating six generals, cutting off their penises with a Gillette racor blade. The plot worked. A million innocent people were killed, Communists called, in effect freedom fighters after centuries of colonization and oppression by Dutch masters.
    Ambitious Catholic priests/inquisitors wrote the Malleus Maleficarum, usuful for other men of ambition for centuries.
    On this sunny March 8th 2014 I’m reminded of the recurrent dream of peace, freedom, democracy, equality. The Malleus Maleficarums of this age have other names. DSM-5 is one of them. The common denominator is usefulness to power, those in power, serving power or lusting for a throne.
    Evil is a potent concept and force with footprints everywhere.

  2.  
    berit bryn jensen
    March 8, 2014 | 4:11 AM
     

    Reminder for more days than this Women’s day:

    LOVE is a potent force too, footprints everywhere – often all over IBOM. Thank you!

  3.  
    Richard Noll
    March 8, 2014 | 10:04 AM
     

    Mickey,
    Thank you again for keeping the discussion going.

    The best outcome for all of this would be Dr. James Knoll, the editor-in-chief of Psychiatric Times, to repost the already published article (6 December 2013) and open up an intellectual exchange of commentary and criticism among psychiatrists, historians and other thoughtful (and rhetorically civil) mental health professionals. I have learned though backchannel sources that this can only happen if I change the text in a way that does not “name names” – a difficult and perhaps unethical thing to do for a historian. There is an extensive paper trail left behind by the protagonists of the SRA era in psychiatry, and I cannot ignore the authors of these publications. To date I have still not been told explicitly what wording or sentences seem to be troublesome for Psychiatric Times, but I am hearing that the reposting of the article is contingent upon such changed to the already edited and published article. Besides, imagine if I complied with such a request: for the rest of my life I would be reading blogs, articles and books which compared the original language of the published article with the sanitized version in the new post. That would become the new story, and the question I raise in my article – specifically, why is the SRA moral panic of the 1980s and 1990s passed over in silence and unknown to young clinicians and historians of psychiatry today? – will again be side-stepped.

    The above-mentioned 2008 article by Dr. James Knoll and his 14 February 2013 Medscape piece on the same issue, “Mass Distraction: Equating Mental Illness with ‘Evil,’” (www.medscape.com/viewarticle/779097_print) makes points that I wholeheartedly agree with, by the way. Dr. Knoll is drawing attention to a serious concern: should psychiatrists be allowed to offer expert testimony in courtrooms regarding whether a defendant is sane, mentally ill, or “evil.” Like Mickey, I am stunned by the mere existence of a psychiatric literature in which this issue is debated. If only the authors of the Malleus Maleficarum had computerized assessment technologies there wouldn’t have been so many “false positive” diagnoses of diabolism back in the day! This seems to be the scientific advance proposed by are other American forensic psychiatrists today who want to keep “evil” as a valid diagnosis but use the wizardry of checklist software programs as the new “hammer.”

    Although Dr. Knoll is too gracious to explicitly say so, the considerable space devoted to this witchfinder’s manual in his 2008 article can be read – if one chooses – as a clever historical analogy between the Malleus Maleficarum (Kramer and Sprenger, 1486) and the computerized Depravity Scale (Welner, 2009).

    As I have stated, I agree with the arguments and intent of Dr. Knoll’s two articles. But if one reads them carefully, the SRA moral panic of the 1980s and 1990s is virtually absent. The two components to the panic were (1) the day care ritual abuse catastrophe, which led to people being falsely accused and imprisoned, including at least one who is still in prison); and (2) the patients in psychotherapy who were encouraged to recover memories of childhood abuse and offered stories of Black Masses, sex orgies, the kidnapping and ritual sacrifice of babies, and sometimes even Satan himself. Multiple Personality Disorder was being diagnosed at epidemic rates, and since the (still unproven) assumption that MPD was due to severe childhood trauma, the possible existence of satanic cults in our midst for the past 2000 years was believed to be a plausible causal mechanism to explain the “millions” of cases.

    As I document in my retracted article in Psychiatric Times, prominent American psychiatrists played a key role in validating, and then extinguishing, this moral panic. But as we see in Dr. Knoll’s two articles, we have references to unhappy Heavy Metal-listening teenage boys who do drugs and absolutely no reference to the massive literature on the SRA moral panic within psychiatry and the other mental health professions.

    This is not to indict Dr. Knoll for deliberate evasion. I, too, found the whole experience so incomprehensible and destructive I ran from it too after my brief involvement as a critic in the 1989 to 1992 period. I fully understand his reluctance to even obliquely mention the day care and MPD/SRA populations and stick to those unhappy white male teenagers of that era who preferred Marilyn Manson to Madonna. (Note: I did too! But that doesn’t mean I was part of a satanic cult.)

    It is easier to look at Evil in The Other (the distant pre-scientific past, or traditional or distressed societies outside the US and Europe today) rather than in us, our professions, or our own immediate experience. Dr. Knoll’s silence about the recent witchcraze here at home lends support to the argument I made in my article: it really is time for the American psychiatric profession, and historians, to have an open and honest intellectual exchange about all this. As Allen Frances noted in his recent blogs on the subject, something like this could really happen again in psychiatry.

    And as I believe Dr. Knoll senses that the psychiatric profession of the 21st century may very well open that door with computerized assessment technologies

  4.  
    March 8, 2014 | 10:41 AM
     

    I’m wondering whether Richard’s proposal for “an intellectual exchange of commentary and criticism among psychiatrists, historians and other thoughtful (and rhetorically civil) mental health professionals” might include some kind of multidisciplinary academic conference looking back at the causes and effects of the moral panic…. This is way over my head (first time I’ve ever thought, much less written, “multidisciplinary”), but a quarter-century later there are still so many puzzle pieces waiting to be thoughtfully and publicly assembled….

  5.  
    berit bryn jensen
    March 8, 2014 | 11:30 AM
     

    That Richard Noll should subtly rewrite an already published article, quickly withdrawn (by the responsible editor) for having ruffled the feathers of some prominent psychiatrists, would be a stain on the reputation of Richard Knoll as well as the ruffled VIPs of psychiatry and the editor, and can neither change the history nor extinguish the printed record.
    Prominent priests, psychiatrists, bankers, politicians in the business of erasing and rewriting history are found out, sooner or later, as demonstrated by diligent Kremlinologists and multitudes of truthseekers.
    Psychiatric Times – the Pravda of American psychiatry?

  6.  
    berit bryn jensen
    March 8, 2014 | 11:46 AM
     

    Sorry for an unintended slip of the tongue and pen:
    I meant to name only the distinguished historian, a man of integrity, Richard Noll, not anyone spineless and prominent.

  7.  
    Arby (Not a Doctor)
    March 8, 2014 | 11:48 AM
     

    Dr. Noll – You wrote And as I believe Dr. Knoll senses that the psychiatric profession of the 21st century may very well open that door with computerized assessment technologies

    Would you explain this connection in more detail?

    Note that I disagree with the Depravity Scale for many reasons, probably the greatest being the disservice, if not harm, it does to the victims of a crime and their unique situations, but I don’t understand how it opens a door to another “witch-hunt”. Wouldn’t this happening again be due to human nature, not a rating scale that is nothing more than a tool used to inflict it on others? What I mean is that the flawed thinking comes first and then whatever tools are around are used to justify it, not that the tool opens a door to this type of thinking.

  8.  
    Richard Noll (also not a real doctor)
    March 8, 2014 | 12:07 PM
     

    Dear Berit Bryn Jensen;
    Thanks for being concerned about a “stain on the reputation of Richard Noll.” I view the public/academic Richard Noll who writes all that stuff as an avatar that has a life of his own, and he does a pretty good job soiling himself. But I thank you for the thought.

    Dear Arby:
    I was referring to the Depravity Scale. In Knoll’s article in the section reproduced by Mickey, there is a glaring reference to the growth of an “industry” of witchfinding back in the day. I read this as an analogical reference to the copyrighted, corporatized, monetized potential of the Depravity Scale. This sort of enterprise is widespread in psychiatry and psychology, as Mickey has been documenting in his blogs regarding a different affair . . . .

  9.  
    March 8, 2014 | 12:15 PM
     

    Dr. Noll and Mickey,
    Thanks for your writing. As noted above “it really is time for the American psychiatric profession, and historians, to have an open and honest intellectual exchange about all this. As Allen Frances noted in his recent blogs on the subject, something like this could really happen again in psychiatry.”
    The laxity of boundaries in our diagnostic nomenclature combined with the power given the expert testimony of psychiatrists in both civil and criminal settings is enormous and should give us all pause.

  10.  
    Richard Noll (also not a real doctor)
    March 8, 2014 | 12:26 PM
     

    Just to bring home my last response to Arby:

    If depravity (evil) can be operationally defined, standardized in a measurable way like credit scores or blood pressure, then we could use this tool outside of forensic contexts to conduct research on children, adolescents and adults to identify persons “at risk” for evil. And if we collect enough of that data, we can intercorelate those “high-risk” and “low-risk” groups with just about any other measures we want, including DNA markers. Isn’t prevention a noble goal? I hope you see what I am getting at here . . . .And what if new items were added to the scale, such as “the act was committed in the service of satanic or other non-Christian groups”? Even standard IQ tests like the WAIS and WISC are updated and revised to reflect changes in cultural norms.

  11.  
    Arby (Not a Doctor)
    March 8, 2014 | 1:06 PM
     

    Richard Noll (also not a real doctor) – This was great, and it gave me quite a laugh. Thanks for that, and for your reply.

    Your point is taken, and please correct me if I am wrong, I read from it that this “sort of enterprise that it widespread in psychiatry and psychology” is at the source of the creation of the Depravity Scale and supports its use to become a fire all its own.

    To explain, I like to have the dots connected between cause and effect because even though I wholly support stamping out the embers of a fire, I like to know what the fire is that keeps spitting them out. It keeps me from getting complacent when a flame is extinguished only to realize later that the fire still burns. And, it helps me to recognize the signs of an ember in the future; I may not always have access to others’ critical thinking skills so I try to build my own. The historical analogy you give regarding the subject of witchfinding is especially helpful to me in this regard and I need to spend some more time on examining it.

    I apologize for waxing poetic about fires and embers. That was not my intent, but instead the fact that I am constrained by a rather simple thought process that often necessitates me dumbing something down to a description in the physical world in order for me to convey my thoughts.

  12.  
    Arby (Not a Doctor)
    March 8, 2014 | 1:08 PM
     

    i was writing my last comment before I saw your latest one. Yes, that is exactly what I was looking for to the connect the dots.

    Thanks much,
    Arby

  13.  
    Michael Welner, M.D.
    March 8, 2014 | 9:54 PM
     

    The problem with Dr. Knoll is not the article that he wrote with reference to the Depravity Standard and Depravity Scale. It is that he wrote the article with a clear misunderstanding and repeated misrepresentations of the research. And, that the article was cleared for publication by peer reviewers who could not possibly have had the expertise in the research to credibly evaluate his article for its substantive relevance.

    It was not a debate; I was offered the opportunity to respond to his article because the editor in chief, Ezra Griffith, was confronted with aspects of Knoll’s article that were not only inaccurate representations of the Depravity Standard research, but were actually academic fraud. Yes, we actually reviewed his footnoting and referencing and a read of what he footnotes is either grossly misrepresented or used grossly out of context in numerous instances.

    The Knoll article on the DS was just a professional attack by a self-styled intellectual who has acted

  14.  
    Michael Welner, M.D.
    March 8, 2014 | 10:03 PM
     

    who acted irresponsibly in this and other contexts. A thread about Dr. Noll’s article is not the forum for elaborating on that. If, however, one has any interest in the academic fraud of the Knoll article, and how the AAPL Journal was notified of same, write me under separate cover and I will forward the correspondence for your own consideration, as it is not confidential. It is just illustrative of how some people attempt to gain professional standing from attacking others to achieve relevance. That Dr. Knoll is now an editor of a publication neither equates with character not maturation, necessarily. Fortunately, this research effort speaks for itself.

    With that said, it is of greater significance that any reference to the Depravity Standard research being psychiatric is again, a misunderstanding of the research. And, any reference to the research as creating some sort of profit enterprise is also mistaken. When validation efforts are complete, the Depravity Standard will not be sold, it will be provided free to courts and the attorneys and law enforcement agencies that will use it. As its lead researcher, I am as primary a source as you can quote on that, and it has always been the case.

  15.  
    Michael Welner, M.D.
    March 8, 2014 | 10:08 PM
     

    Richard Noll,

    The application of the Depravity Standard does not lend itself to prognosis about children. It applies only to the actions one undertakes in a given instance, and is an evidence inventory that draws from forensic and non-forensic evidence all across the forensic sciences.

  16.  
    Michael Welner, M.D.
    March 8, 2014 | 10:14 PM
     

    Moreover, the Standard is not a computerized assessment. It is informed in part based on sampling public participation in surveys at http://www.depravityscale.org, and merges data from higher court decisions, public input on examples of intent, actions, and attitudes, and data from hundreds of case files of adjudicated guilty murder, assault, and non-violent felony defendants. The operationalized approach to distinguishing the worst of crimes is precisely to enhance the ability of sentencing to be evidence-driven and not arbitrary or vulnerable to prejudice, including from history and prognosis.

  17.  
    berit bryn jensen
    March 9, 2014 | 7:06 AM
     

    People posing as scientific psychiatrists, who object to getting their feathers ruffled, are confirming mainstream psychiatry as quasi-science. They remain stagnant in positions of prominence, craving confirmation and admiration instead of looking over the facts to glean new (or hidden, forgotten, old) knowledge.
    Whenever academic psychiatry trots out it’s fondness of abstractions, elevating it’s more or less scientific methods above ethics, empathy, humane wisdom and judgment, I take refuge rereading Richard Feynman and honest historians of medicine like Roy Porter, Richard Noll, dr Peter Gøtzsche, the science journalist , author Robert Whitaker … and 1BOM

  18.  
    Arby (Not a Doctor)
    March 9, 2014 | 7:24 AM
     

    Michael Welner, M.D. – I appreciate the information on how the Depravity Standard is intended to be used, and that it is not going to be a commercial product.

    I have additional questions on it that I will quickly describe below, yet similar to the fraud discussion, I doubt this is the best forum for them. If you can direct me to a place where I can find a discussion of these questions, the answers to them or how you can be contacted, I would appreciate it.

    1. Why was a poll that uses self-selection chosen?
    2. I perceive instances of selective application of hate-crime laws that concern me, how would use of this standard be any less open to this selective application?
    3. I envision how this can be used to bring justice in sentencing, yet how would it be used to bring justice to victims? Relates strongly to my second question.

    As you can see, I am not not well-versed in this subject, so it would be information for the layman that I requesting.

    Thank you,

    Arby

  19.  
    March 9, 2014 | 11:23 AM
     
  20.  
    Richard Noll (not a forensic psychiatrist)
    March 9, 2014 | 12:55 PM
     

    I just wanted to add one brief, and perhaps, tangential point about the use of “validated” standardized tests and scales (AKA “instruments,” a term that betrays the inferiority complex at the heart of social science research with respect to things like microscopes that grown-up scientists use):

    There are historical examples of “objective,” “validated” scales which gain general acceptance for use that find ways to mission creep into uses in ways for which they ere not designed, validated, or intended to be used.

    Let’s step back from the adrenaline whoosh of our discussion of the construct validity of “evil” (depravity) and let me offer an example of a typical unintended consequence of the acceptance of an instrument that was designed to evaluate aspects of human nature;

    In graduate school in NYC in the early 1980s my clinical training was thoroughly psychoanalytic. Biological theories were mentioned but viewed as an irrelevant sideshow. As clinical psychologists-in-training, we all had to learn how to administer and score (by hand! no computer programs to write our reports or do our math!) psychological tests such as the Wechsler Adult Intelligence Scale (the famous WAIS). This was, and is, a well-regarded standardized test of generalized intelligence (we might say cognitive functioning today). The test was not designed nor validated for any other uses than getting Full Scale, Verbal and Performance IQ scores. Is that how we were taught to use it? No. The IQ scores were the least important aspect of the IQ test unless thre was a question of borderline IQ or mental retardation.

    No, were were thoroughly trained in the analysis of the responses to the test items as if the WAIS were a projective test. Using psychoanalytic theories, we “read into” the responses and were trained to comment on individual items in this way in our psychological reports.

    The WAIS was not designed nor intended for such use, and yet this is how it was widely used by clinicians in that era. This violated all scientific norms, it violated the explicit instructions of the makers of the test, but the social norms of that clinical era encouraged us all to forget the WAIS’s origins and do with it what we damn well pleased.

    The point is that no matter how well-intentioned the development and standardization of a test or scale may be, once it’s underlying theoretical construct (say IQ or evil) gains consensual acceptance (construct validity), these progeny of their creators adapt, evolve and are used in ways never even imagined. Unintended consequences are a familiar story in history.

  21.  
    Arby (Not a Doctor)
    March 9, 2014 | 1:58 PM
     

    Richard Noll (not a forensic psychiatrist) You slay me!

  22.  
    March 9, 2014 | 2:04 PM
     

    Richard, your last paragraph takes me back around to “satanic ritual abuse” and Dr Roland Summit’s five-stage “child sexual abuse accommodation syndrome” (CSAAS), which prosecutors used to persuade jurors in cases such as McMartin Preschool. Summit later — too late for too many — distanced himself from his theory’s “unintended consequences.”

  23.  
    Arby (the Village Idiot)
    March 9, 2014 | 2:58 PM
     

    Richard Noll
    Michael Welner, M.D.

    For what is worth, I think you both are correct. That the intent of the Depravity Standard is as a tool to be used for a specific behavior at a specific point in time to address a current mess in the legal process. However, odds are high it will beget an opening for evil individuals to use the construct, if not the form itself, for evil purposes while clueless and/or careless others go along with it.

    This is why I asked my original question. Evil doesn’t need this particular form to practice evil. Yet, why not attack what they try to do outside of this? I don’t even think attack is the right word. It is obvious that evil isn’t going to go away. Much more beneficial to try and reach the clueless and the careless, and that is not an attack.

  24.  
    wiley
    March 9, 2014 | 4:17 PM
     

    Why not ask patients who have done no evil, as far as anyone can tell, and who are in crisis or are overwhelmed by defeat if they have been the victim of depravity and what that might depravity might be. Psychiatrists aren’t going to prevent evil itself, so why not acknowledge that a lot of what they often call “mental illness” is a natural reaction to having been the victim of depravity?

  25.  
    Michael Welner, M.D.
    March 9, 2014 | 4:51 PM
     

    Arby (And anyone else who is interested),

    I invite your correspondence with questions, to drwelner@forensicpanel.com. I appreciate the questions and critique and will either address concerns in coming published articles (or will not be able to if such shortcomings are to be reconciled). But I will read them carefully and reflect upon them at face value and appreciate anyone taking the time to write. It is refreshing to critique this effort from a vantage point that matures beyond misinformed hysteria. We have to do that every day. Thank you for weighing in.

  26.  
    Richard Noll
    March 10, 2014 | 8:55 AM
     

    I’m sure many of you have seen this by now. This is a 13-minute documentary in which both Debbie Nathan and Ken Lanning are interviewed about the day care ritual abuse moral panic, which apparently broke into the national news exactly 30 years ago this month.

    http://www.nytimes.com/2014/03/10/us/the-trial-that-unleashed-hysteria-over-child-abuse.html?hp&_r=0

  27.  
    berit bryn jensen
    March 10, 2014 | 10:20 AM
     

    Thank you, professor Noll.
    In 1992 a similar case broke in Norway, known as the Bjugn case (Bjugn saken) after the community were the bug hit in a day care center, and developed to engulf more and more children and adults. When the local sheriff was implicated with a handful of other prominent persons, I felt sceptisism and disbelief, later confirmed by the long unravelling on the road towards verdict in the European Council’s Court of Human Righsts in Strasbourg, finding in favor of the plaintiff, the male day care center worker first accused. So many children, parents and adults maimed by the hysteria, to this day…..
    As for a standardized definition of evil or depravity, there are every reason to suspect misuse by whatever powers there are anywhere. May I respectfully suggest to dr Welner that the case of Anders Behring Breivik has relevant lessons.
    We may certainly agree that his Act of killing 77 humans was evil. But many mainstream psychiatrists in Norway agreed with the first forensic evaluation labelling him with the diagnosis paranoid schizophrenia. The second evaluation (courtordered, most unusual) diagnosed personality disturbance. The court found him sane, thanks to critically, independently thinking judges, headed by a female judge, under enormous pressure from established, mainstream psychiatry, which lost face and respect, I think..
    My impression was that Breivik is sane, selfpoisened on hate and rightwing extremism, which may have given him a feeling of belonging.??? Human rationality is so often irrational, as history shows. Power is a mighty driver of calamities
    .

  28.  
    March 10, 2014 | 11:49 AM
     

    The Danish filmmaker Thomas Vinterberg cites Bjugn as an influence on his 2012 day-care abuse drama, “The Hunt”:
    “People were judged so quickly. In one case that I read about from Norway, I think 40 something people ended up in prison including the local sheriff. What fascinated me, was that you’d have 18 children coming up with the same precise descriptions of men in monk costumes, being forced to eat feces, the colors of the walls. All sorts of details that were all identical between the kids and then they’d go check the house and there’s no basement, like in our movie. So this collective fantasy gets so specific and so detailed on the playground. This film is a much more civilized version of what actually happens. We made it watchable. We made the airplane version of real life.”

    http://collider.com/thomas-vinterberg-the-hunt-interview/#TSUC3k6dc5ZYLCRo.99

  29.  
    wiley
    March 10, 2014 | 5:45 PM
     

    The Hunt was a powerful film. People find it hard to forgive their victims for what they’ve done to them. I think in many ways, this is relative to the satanic panic and a whole lot of psychiatry.

  30.  
    Richard Noll
    March 14, 2014 | 11:05 AM
     

    FYI:
    Since the only website that allows for access and downloading of my unpublished published article is Gery Greenberg’s, I have also made a PDF of the article available on Academia.edu:

    https://www.academia.edu/6400228/_When_Psychiatry_Battled_the_Devil_Psychiatric_Times_6_December_2013_

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