Thursday, February 14, 2008

Psychology: Riskier than You Thought

I have a piece up at PJM in response to yesterday's brutal murder of psychologist Kathryn Faughey in her NYC office:

Reacting to yesterday’s gruesome murder of New York therapist Kathryn Faughey, Dr. Helen Smith is both horrified and surprised it doesn’t happen more often.


Many professions are risky, but people imagine a psychologist's office to be fairly safe--but this is not always the case. Go read the column to see the stats on the number of us who are stalked, harrassed and threatened.

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22 Comments:

Blogger Brian said...

I hope there's a comma missing from that blockquote.

2:57 PM, February 14, 2008  
Blogger Helen said...

Brian,

Actually, there was a period missing. Thanks, not sure what comma you are referring to?

3:07 PM, February 14, 2008  
Blogger wild chicken said...

Good reason to carry, if the law allows of course.

4:46 PM, February 14, 2008  
Blogger Helen said...

Carol Minjares,

The problem is that most psychologists do not believe in carrying guns and will do very little or nothing to protect themselves save for installing a panic button and hoping the police show up. I remember working at a place years ago that had a panic button that went to a security office. One day, we accidentally set it off. About twenty minutes later, a female security guard with no weapon showed up to ask if we were okay. We all realized that we were toast should we really need someone in an emergency.

4:52 PM, February 14, 2008  
Anonymous Anonymous said...

I'm sure the Doc has dealt with some scary people in her career. Did you ever feel threatened by any of your clients? Maybe not even having their anger directed toward you, but just feeling that something in their relationship with you was becoming unhealthy?

Seems like a certain number of clients might become obsessed with the therapist; but not in a romantic or sexual way. Do they ever dump all their issues on you, expecting you to "fix" them or somehow blaming you when their problems don't get better?

The present guy was in control enough to apparently plan a kidnapping and walk into the building without causing suspicion. I wonder what set him off. Also wonder how he got away - assuming he was covered with blood.

6:25 PM, February 14, 2008  
Blogger Helen said...

Bugs,

The killer in this recent case knew how to get out of a basement door so probably knew the building. Yes, I have dealt with much during my career including being punched in the face, hit with a belt, and more that I will not get into.

I imagine they will find this guy soon since they have video and descriptions and hopefully more evidence. This did sound more like a predatory type of killing rather than one that is affective, that is, he just went off in an emotional rage or it could have been a combination. Let's hope he is caught soon.

6:37 PM, February 14, 2008  
Anonymous Anonymous said...

I am a prison counselor in a maximum security facility. I fully expect to have a former prisoner show up on my doorstep someday, not because I've done anything wrong, but because of the population I handle.

I had a prisoner who is getting out in a few months ask me the other day, "What would you do if one of us called you on the phone some day or came to your house?"

Creepy.

7:37 PM, February 14, 2008  
Blogger Doreen Orion said...

My first book was about being stalked for 11 years by a former patient I'd treated for 2 weeks on an inpatient ward. When it started in 1989, my psychiatric colleagues seemed to think I must have done something to cause it.

Actually, her outpatient male psychiatrist should have warned me when I called him her first day as an inpatient to get collateral information. Unfortunately, he neglected to give me her history of stalking several woman "authority figures" over the years, which he knew about. She had erotomania. In fact, when I told him what was going on once she started stalking me after discharge (which eventually included multiple restraining order violations, arrests, coming to my home and following me to another state after my husband and I moved), he said, "I was afraid this would happen."

Little was known about stalking then. It wasn't even mentioned in our training. Fortunately, that seems to be changing - somewhat.

8:39 PM, February 14, 2008  
Blogger a psychiatrist who learned from veterans said...

It is evidence for what is traditionally called transference, called so on the hypothesis that feelings toward the important others in a person's development are 'transferred' to the therapist or doctor. And people don't see therapists because of 'happy feelings.'

8:49 PM, February 14, 2008  
Blogger DADvocate said...

When I worked at the mental health center we had patients who had committed murder. One day a paranoid schizophrenic ex-biker became threatening. We called the police. They took five (5) knives off of him, switchblades, hook blades, etc.

Several staff members experienced attacks similar to DrHelen's. Mental health work can be very dangerous at times.

9:22 PM, February 14, 2008  
Blogger Helen said...

Doreen Orion

What an awful experience. I agree that little was known in the late 80's about stalking and little was done. NYC did not even have anti-stalking laws in the 80's so there was nothing that could be done if one was being stalked. Did you ever read "Love's Executioner" by Yalom? He has a good description of the erotomaniac stalker.

12:39 AM, February 15, 2008  
Blogger TMink said...

I was threatened once and I threatened back and he left me alone. He even agreed to terminate parental rights to the child he had molested when court came around. I am glad for her, but I was eager to testify.

The VA psych floor at Murfreesboro, TN does it right. Whenever there is a problem with an aggressive patient, the intercom asks for Dr. Armstrong to come to the trouble spot. When that page comes on, everyone drops what they are doing and runs to the announced location.

I saw resistant, psychotic patients surrounded by 40 men and women who were rolling up their sleeves and taking off their glasses, getting ready to take the guy down. It was quite a sight! And it is also amazing how really crazy patients were almost never so crazy as to want to fight with 40 people.

Trey

10:01 AM, February 15, 2008  
Anonymous Anonymous said...

I sometimes thought my own LCSW was pretty brave. She was frequently in her office alone, or sometimes with a secretary in the outer office. Not that I'm any trouble, but some of the other folks in the waiting room were kind of scary looking.

10:19 AM, February 15, 2008  
Blogger Helen said...

Trey,

That's right, seems that even those who are psychotic often stop their aggressive behavior when they find out that someone stronger or with a weapon is present. Only the most psychotic or ill will keep fighting in those circumstances--hence the "policeman at the elbow" test for insanity. If a person still commits a crime with an officer with a gun present, it's more likely he is insane.

10:28 AM, February 15, 2008  
Anonymous Anonymous said...

Could be he's just stupid. Ever watch "Cops?"

11:17 AM, February 15, 2008  
Blogger newton said...

Dr. Helen,

Who could have imagined how much of a risk you have taken by being involved in the "science of the mind"! I hope you can defend yourself with everything you've got, should the situation arise.
Besides, this has touched me more personally than I thought.

I knew Dr. Faughey: she was my therapist years ago. At that time, I had finished a disastrous first year of college and of life away from home. I was in a deep hole, emotionally. She helped me stop digging.

She also knew my older sister, at least professionally. Little did I know until today that Dr. Faughey and my sister had been close friends for over thirty years. (My sister had no idea about her murder until I e-mailed her the linked article on your PJM column.)

She's now grieving, but me? I'm angry. Angry at the fact that the most obvious path to catching Dr. Faughey's murderer is shut to investigators, because of patient confidentiality.

When a killer shouts "Nobody's helping ME!", that says volumes. He may not be a patient of hers, but that doesn't matter. My gut feeling is that someone else she treated knew him as well, and that someone else is also a victim of this deranged murderer.

I'm sorry I have to vent out on this here, but I don't know whom to talk to right now. Thanks for giving me a chance to do it.

2:48 PM, February 15, 2008  
Blogger Serket said...

tmink: the intercom asks for Dr. Armstrong

I've heard about hospitals using a fake name to signal an emergency, perhaps it was in a movie.

Bugs - My dad loves that show.

3:17 PM, February 15, 2008  
Blogger Helen said...

Newton,

I am sorry that you lost someone close to you who helped you, she sounded like a wonderful person. I understand feeling angry, I feel the same way. I think the anger comes from the unfairness of a mental health system /advocates who care more about confidentiality than they do about a finding someone who is a killer and may still be out there and who is potentially dangerous. I have read that the family of Ira Polonsky is also asking the same question, "Why are these records so difficult to obtain and investigate?" I realize that patients have the right to confidentiality but we break that when our patients are a danger to themselves and others, why not when mental health workers are actually killed? I agree that this sounds like a patient or more likely, someone who knows a patient. I once had a case where I was asked to evaluate a woman whose ex-husband was stalking her. The facility I worked with told me that he had called threatening to kill me. I made sure I had a security guard with me that day--nothing happened but why take the chance. I think that with more and more people being turned away by mental health hospitals and being treated more in the community with little or no supervision, we will see a rise in some violence against mental health workers--just as we are seeing the mentally unstable acting out in the community.

Thanks for stopping by--you are welcome to drop me an email at drhelenatviolentkidsdotcom if you would like to talk further.

4:21 PM, February 15, 2008  
Anonymous Anonymous said...

serket - In our local system, paging Dr. Red means there's a fire and Dr. Brown means a toilet's overflowing somewhere. Strangely, though, when they want to call security they page the Assistance Team.

11:10 PM, February 15, 2008  
Blogger Obernai said...

This is a real tragedy that will hopefully lead to changes in the system.

It is ironic that just the next day, we had a patient become quite threatening in rounds. I am a post-doc and was with his psychiatrist and case manager. His anger was directed at both me and his psychiatrist. We followed the proper security procedures of course, but it was pretty disturbing after the news of Dr. Faughey's death.

Interestingly, during our post-session discussion, the idea was put forth that there may be some organic changes accouting for this sudden change, in lieu of psychopathology. (for both this this patient and the one in the news without knowing any details of course). Sudden major personality change and all - a scary thought for those in the profession when something biological can create such change in behavior that does not respond to standard therapeutic intervention.

6:23 PM, February 16, 2008  
Blogger a psychiatrist who learned from veterans said...

obernai - I was accompanying Dr. Charles, an older psychiatrist, interim chief at a VA, to the nurses station one morning. Someone come up to us and spoke to him in a hostile, accusing manner to which he replied mildly. When he got to the nurses station, he ordered on the patient's chart, 'Mellaril (a then current antipsychotic drug) 100 mg tid (three times a day).' I assumed this was on an assessment of psychotic transference. Also I was taught that depression in a brderline personality responds better to low dose antipsychotics than to 'antidepressants.' My point is, I guess, to wonder 'standard (for what) therapy?'

7:58 PM, February 16, 2008  
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