Wednesday, August 30, 2023

The Story of Scheherazade: A Fable for JwSO Therapists of Transformation through Care and Conversation (part 2 of 3)

 By Norbert Ralph, PhD, MPH, Private practice, San Leandro, CA

This is the second part of a three-part blog (link to part 1 here) about the Fable of Scheherazade, the central figure and storyteller in "The Book of the Thousand Nights and a Night" from classic Persian literature (Burton, 1885). This second part explores if the myth gives any clues to how Scheherazade transformed the King and stopped his evil actions that parallel the work of JwSO therapists? Several factors can be hypothesized using the lens of present psychotherapeutic practices.

Knowledge and Skill: Scheherazade's faith that she could transform the King is one of mythology's great fables of selflessness and optimism regarding prosocial possibilities in others. Scheherazade, like the JwSO therapist, however, did not go into such a struggle with faith alone. The fable notes she was a beautiful and learned woman who was highly educated. The JwSO therapist approaches their task likewise, well-prepared with a formidable set of best practices and evidence-based methods.

Holding Environment: Winnicott (1960) used the term "holding environment," which has been used to describe the setting and relationship that permits the patient to experience safety and facilitates psychotherapeutic work. Scheherazade, like the JwSO therapist, created a safe setting which put implicit limits on the King's harmful behavior but without coercion and encouraged prosocial problem-solving in the context of caring conversation. It created an environment where not only the King but Scheherazade and implicitly the Kingdom were safe.

Corrective Interpersonal Relationships: Alexander and French discussed a therapeutic factor, the "corrective emotional experience" (Alexander & French, 1946). This referred to the idea that individuals bring into therapy dysfunctional and self-fulfilling behaviors and narratives regarding relationships. Therapy itself can provide corrective new experiences in relationships that can become a template for the patient for more positive future relationships. The King's narrative that women were unfaithful and selfish and deserve to be killed was contraindicated by Scheherazade's behavior daily for a thousand nights. Each day she survived meant one less woman killed at the risk of her own life and affirmed her belief that the King could be transformed. Like Scheherazade, the JwSO therapist's optimism about a prosocial future for the youth along with relevant knowledge and skills can become self-fulfilling when others doubt such an outcome.

Patient Autonomy and Motivational Interviewing: Scheherazade, like the JwSO therapist, respected the autonomy and dignity of her client, the King, to find his own reasons for change. For a thousand nights, at the end of each story, Scheherazade gave the King a choice of what he wanted to do. The choice to continue a prosocial dialogue was the King's alone. Similarly, the therapist cannot "make" the JwSO youth pursue a prosocial dialogue in therapy but must give the youth the autonomy, with guidance, to find their motivation. Coercive therapy is a contradiction and an impossible idea.

Prosocial Parables: Scheherazade's stories were prosocial parables that provided information and ideas about how people could exemplify virtuous behavior, overcoming challenges, and lead more prosocial lives. Likewise, the JwSO therapist may use stories or parables as a way to teach the youth prosocial models regarding relationships and consider one more prosocial perspective or behavior to better obtain the goods of life and create a prosocial lifestyle. This was exactly the technique that Hamlet used with the play when he said, "The play's the thing Wherein I'll catch the conscience of the King" (Shakespeare, 1603).

The third part of this blog will be published shortly will continue the discussion of look at the therapeutic aspects described in the fable through the lens of present psychotherapeutic practices. It will also discuss the therapist's identification with heroic roles while being a source of possible strength can also create vulnerabilities.

Friday, August 18, 2023

How the Online and Offline Worlds are Intertwined

 By Kieran McCartan, PhD, Kasia Uzieblo, PhD, and David Prescott, LICSW

There is ongoing debate in many countries about the online grooming of children for abuse and sexual exploitation. The debate in the UK currently involves the online safety bill, which is making its way through the House of Parliament. Debates regarding how best to protect children are not new, and although it is an important topic, it is only part of a broader question.


Beyond efforts to end grooming are questions about online safeguarding, corporate responsibility, and who polices the internet. Unfortunately, not many governments are clamoring to deal with these issues; there are many divergent special-interest groups, ideologies, and vested interests. There are also legitimate questions about the limits of privacy and free speech. We often hear that an attack on the internet is an attack on free speech and that by limiting online behaviors we are limiting free speech and creating a dystopian, big-brother state. One often-unspoken perspective in this is the need to consider the crossover between online and offline social harms.


This week the National Society for the Prevention of Cruelty to Children (NSPCC) reported that children were at more at risk for online grooming than ever before (an increase of 82% in 5 years) They further reported that there have been increased levels of reporting alongside a need for more safeguarding. Although it is true that there is more reporting, recording, and observing of socially inappropriate behavior online (including but not restricted to sexually exploitative behavior) we need to keep in mind that there are a range of explanations for this beyond the inappropriate behavior itself. For example, there is better detection, more confidence in reporting, more police and justice reaction, and better-informed communities responding to it.  Further, the world after the #metoo movement has seen a greater acknowledgement of abusive behavior (and calling it out when it happens) and better responses to it. And yes, there is also more acknowledgement of online sexual harm; but the question is what do we do about it?

 

In the UK, the online safety bill, although quite debated by this point, wants to hold internet providers and website owners responsible for content on their platforms and that they could be as culpable as the people who post on them. There is pushback to this by many who state that the internet is the last bastion of free speech, and that protectionism has gone too far. On the other hand, the internet is not the wild west of older times, and moderating content needn’t be invasive.

 

It is tempting to see these debates as centered exclusively on free speech; there is no question that this is a central concern. Too often missing, though, are coordinated efforts by experts from the various professional disciplines that contribute to the wellbeing of children: Victims’ services, child protective services experts, researchers who study those who perpetrate online offenses, and those with expertise in domestic and other forms of interpersonal violence. It is difficult to imagine how the internet can become safer without these voices at the table, collaborating with one another, and sharing knowledge.

 

It is well known that online context can affect offline behavior, shape attitudes, influence behavior, and result in abuse. In fact, it’s a two-way street, with offline behavior also affecting the online world. In many ways, the age-old distinction between these worlds may no longer serve society well.

 

Further, we have seen from conversations and research on incels, pornography, abuse, and violence against women and girls that the online and offline worlds are not segregated communities. We know from discussion with clients that online and offline actions and attitudes and impact their decisions to engage, or not engage in, abusive behavior. This is not to say that everyone is impacted by the internet and online context in the same way, but clearly the internet and online content can impact people. Therefore, if something is abusive offline, should it not be considered the same online as well? A clear example of this is a campaign from Australia discussing the harm of strangulation pornography.

 

This blog post started with the rise of online grooming and is ending with a discussion on the lived experience of online behavior. One may ask why these two are linked; the simple answer is the implicit and often-explicit online message that abusive behavior is acceptable. Our hope is that communities can get a better grasp of what really happens online, and what the implications are for the most vulnerable members of society. That requires stepping up and asking hard questions of ourselves, our communities, and the systems that are involved in them. We need to see the online world as an extension of the offline world, and vice versa, not just separate entities. The sooner that we come to terms with the full extent of abuse and exploitation happening online, the sooner we can do something about it.


The question remains as to how we then best meet these challenges. Holding providers and website owners more responsible may be a necessary move to motivate them to really do something about the problem, even though it is not hard to imagine the legal questions that will arise from this. It is all-important that we continue to have this conversation about our shared responsibility and that we do not shy away from the complex challenges and issues, whether about online or offline behavior.

 

 

 

Wednesday, August 9, 2023

How horrific cases prove the need for prevention

By Kieran McCartan, PhD, & David Prescott, LICSW

Criminal justice policy is often written in the wake of high-profile, horrific cases. Living up to the axiom that “bad cases make for bad laws,” the rationale for reactionary policymaking, which is often punitive, is that it will act as a deterrent for would-be offenders and those that have been caught will learn their lesson. However, this assumes that people make rational choices to commit a crime, and that they will change their behavior based on the consequences of their behavior. Over the years research has taught us that this is not necessarily the case, and that prevention is often better than deterrence or punishment. When it comes to discussions of preventing/deterring/treating sexual abuse, this is a tightrope that we have been walking for years, with prevention making sense with professionals and policy makers, but the practicalities of it often becoming hard to implement across society.  A recent case from Australia and the reaction to it from policymakers suggests that tide is changing and that high-profile cases do not need top lead to a reactionary, putative response, but rather an opportunity to learn and add to the case for prevention.

Last week, Australian police charged a former child-care worker with abusing 91 girls over the course of 15 years, involving 1,623 charges, including 136 counts of rape and 110 counts of sexual intercourse with a child under 10. In addition, the person in question also photographed and recorded most of this abuse, posting it online through the dark web. The offenses took place between 2007 and 2022, while the unnamed childcare worker worked across 10 child-care centers, mainly in Brisbane. The police have identified 91 children, 87 of whom are Australian.

This case is horrific and highlights abuse over a significant period. It would be easy to see how this case could lead to a punitive criminal justice response, and yet his offending was so persistent and thought out that it illustrates what research tells us about deterrence: That the threat of imprisonment did not stop him, but the likelihood of being caught might have.

While holding the person who has committed the abuse to account is of obvious necessity, we need to do more than that; we need to learn what happened, how it continued, what (if anything) prevented bystanders from intervening, and then introduce effective measures for prevention and stopping abuse as early as possible. The case highlights how there were probably multiple points where disruption and intervention could have happened. Therefore, those invested in prevention still need to think more about upskilling communities, improving knowledge around child sexual abuse, and increase strategic community action, bystander invention, and empowering appropriate organizations to help.

One of the Australian leaders and policymakers that responded to this case was Dr. Leanne Beagley. Dr Beagley is the National Centre for Action on Child Sexual Abuse, which was formed out of the findings of the Australian Royal Commission into Institutional Responses to Child Sexual Abuse. She has discussed the need for us all to come together to prevent child sexual abuse and that it is all our responsibilities. Hers is a clear government/policy voice in favor of child sexual abuse prevention and indicates that the socio-political tide is changing regarding this. We need to do more to get political and policymakers on board with the prevention child sexual abuse, with Australia being the example that we need to evidence.

Everyone wants to deter people from offending, and yet we have yet to implement the right policies and procedures.