I FIND IT IRONIC that the Monitor covered many areas of self-care for psychologists--exercise, losing weight, meditation, relaxation, massage, balancing work-life demands, getting away, self-assessment--but buries an important one on page 64: personal psychotherapy. The former reflect that American ethos of self-sufficiency. The latter requires trusting someone else to help you see yourself in ways that you can't discover alone. How many academics, researchers, administrators, supervisors and even clinicians would consider such an option for ourselves, even though so many of us provide it or recommend it to others?
LYDIA KHURI, PSYD
AS A CLINICAL PSYCHOLOGIST who practices meditation, who uses it in therapy, and whose dissertation studied it, I was pleased to read Bridget Murray's article in the July/August Monitor. However, I think it is essential to inform readers that an "understanding of Eastern philosophies" is not only important, but critical, since both "mindfulness" and meditation are fundamentally rooted in their respective religious traditions (Buddhism and Hinduism).
If the meaning people are encouraged to make from meditation is grounded in a specific spiritual paradigm ("Every individual has within them the seed of their own happiness"), then they should understand the basis for these interpretations, and know that they are free to make whatever meaning they choose. I suggest that we define meditation sessions as brief, single subject experiments in which we can be open to learning about our thoughts, emotions and actions from a cognitive-behavioral perspective. I also question whether the research cited is "groundbreaking," since the body of meditation research, dating back to the 1960s, has consistently shown that meditation is no more effective than simple rest, napping or sitting quietly. As a scientist-practitioner, I am compelled to ask if researchers who subscribe to specific beliefs about their personal meditation may have something to prove. Unfortunately, asserting that being quiet, dozing and engaging in passive activities (that our society usually defines as being lazy) does not share the same mystique.
M. DUNCAN CURREY, PHD
Case scenario: A young adult describes past child abuse and asks the therapist not to report it. Question: Is the therapist ethically permitted to breach confidentiality and report anyway, even if reporting is not legally required? The expert respondents covered some impressive ethical, legal and clinical territory. But no one asked the most important ethical question: "What was this client told at intake?"
The APA Ethics Code requires that the limits of confidentiality be discussed "at the outset" (Standard 5.01b), "as early as is feasible" (Standard 4.01a). The informed client can then consent to those limits as a condition of receiving services. Voila! Informed consent!
The obvious solution. Are we prepared to implement it? Timing is important: If we intend to report past abuse, we must say so before eliciting confidences we might later betray. Preparation is essential: If we don't yet know what our intentions are in such foreseeable situations we are probably making (or implying by silence) confidentiality promises we will later break.
Such ethical dilemmas can be avoided--and clients' rights protected--only if psychologists clarify their own intentions in advance and explain them at intake. Dr. Behnke's helpful metaphor, "Three Ethical Doors to Disclosure," can be used to create a reminder: Our first--and sometimes our only--opportunity to open the "client consent door" is at the initial interview.
MARY ALICE FISHER
I HAD JUST FINISHED A MANUscript entitled "Thurstone Equal-Appearing-Intervals: the forgotten method" when I picked up the Monitor to discover that the "e" was left off L.L.Thurstone's name on the list of the top 100 psychologists of the 20th century. The error was first printed in the Review of General Psychology. Fame has a poor memory and a sense of irony.
WILLIAM E. SEDLACEK
University of Maryland