The fallacy of legislating behavior
A recent conversation and a 2014 Ted talk to which I listened for the 2nd or 3rd time this morning prompted me, one again, to think about the role of rules in my professional and personal life.
The recent conversation occurred because I am in the process of moving and will have to decide if I am going to conduct my greatly reduced psychotherapy practice out of my home or to continue to only interact with client via. phone, face time/skype, email, and text. There are some legitimate concerns about whether I see client in a home office. If one has a home office, then there are insurance concerns in case a client falls or otherwise gets hurt on the premises. Type of insurance also is affected by the amount of expensive office equipment one has. I understand these concerns.
One might think it is simple to decide if one is doing business in one’s home and then make appropriate decisions regarding insurance. This is not always the case. For example, I am moving back to the geographical area where I had a large home psychotherapy practice for a number of years. Many of those who periodically employed me were also colleagues. Thus, I had, what is usually referred to in our profession as dual relationships with many people. One moment they might be there as a colleague or a friend and the next they might be there for clinical consultation in my role as clinical supervisor or they might be there as a client. Sometimes folks who previously were clients stop by to share with me how well they are doing, to ask a brief question or for a “refresher moment”.
There are those individual who very clearly want and need a very specific appointment for “therapy” and/or those who clearly need me to stay in the therapy role any time I see them – even at the local grocery store. Those are limited relationships
I am also 76-year-old which, for some, clearly put me in the role of mentor, elder, substitute uncle or grandfather to whom they come for a listening ear, direction or advice. Some of these may have previously been a client and some may not have been.
When I functioned in a full time psychotherapy practice I had an office manager who often did more therapy/counseling that I did. She was not licensed but she was often the one to whom people talked when they called or while they were waiting to see me. She was a very wise, compassionate person who clients/patients considered an equal member of the healing team. There was a gifted and loving person who helped with cleaning. If she was there when a “client” stopped by they might chat with her. For a time, there was also a psychiatrist who used another office in my home part-time. She talked to my clients and I talked with her patients.
Both the psychiatrist and I are licensed by the states in which we practice We also are members of professional organizations. Each licensing board and professional organization have an ever expanding written code of ethics which attempt to cover every possible scenario between a professional and their clients/patients. These rules are an attempt to clearly define who is a client/patient, the boundaries of the relationship, how to protect confidentiality, and what to do if a professional is abusive or inappropriate. The theory is that professionals cannot be trusted to decide what is ethical and appropriate and that every person and situation can be viewed through the microscope of these many rules. Different professional organizations often have different rules.
Clearly clinicians –therapists, physicians, and others – are sometimes inappropriate. Some live with various additions or other conditions which may not be successfully treated – alcohol, drug, money, power, sex, food and other addictions which may adversely affect their behavior with clients/patients. If the addiction or other illness is in charge, that person cannot be effective in their professional or personal roles. Clients/patients need to be educated about how to fire those individuals. Theoretically they can also report that person to the professional organization so that they can get help. In practice the clinician may be punished rather than helped and/or may be sued for “damages”. Clearly we need to identify and help those clinicians and also sure that clients/patients get the help they need.
I am not convinced that having a very detailed code of ethics is helpful for the clients/patients or the clinicians. There is really only one rule: Keep the needs of the client primary. If one does not have the time, energy, health, or expertise to help a client/patient then one needs to help the client/patient find the type and level of help they need. Most mental health clinicians know that the number of rules does not usually correlate with creative performance for adults or children. Ye, we continue to operate as if that is the case.
We also do the same in the workplace, in schools, in government agencies and business organizations. We seem to begin with the assumption that people of any age cannot be trusted. We spend a lot of energy attempting to prevent sloth, laziness, cheating, or any other way of failing to “behave” appropriately. This brings me to the October 2014 Ted Talk by Ricardo Semier, “How to run a company with (almost) no rules. Mr. Ricardo’s company was/is:
“…a complicated company with thousands of employees, hundreds of millions of dollars of business that makes rocket fuel propellent systems, runs 4,000 ATMs in Brazil, and does income tax preparation for dozens of thousands. So this is not a simple business.”
He and others in the company:
“… said things like, why can't people set their own salaries? What do they need to know? There's only three things you need to know: how much people make inside the company, how much people make somewhere else in a similar business and how much we make in general to see whether we can afford it. So let's give people these three pieces of information. So we started having, in the cafeteria, a computer where you could go in and you could ask what someone spent, how much someone makes, what they make in benefits, what the company makes, what the margins are, and so forth. And this is 25 years ago.”
They let employees decide when to work, what to wear to work, how much they needed to accomplish and many other aspects of their work life. The company thrived. Certainly there are times when a person is unable to do a job or is not a good fit for this atmosphere, but, in general, most people functioned better when treated with respect.
Mr. Ricardo has also successfully worked with schools to basically apply the same principles.
These concepts are also consistent with the theories of such workplace consultants as Margaret Hefferman who talks about the social contract in the workplace as well as with the experience of those who manage Silicon Valley startups companies.
It would seem that if we want to bring out the best in each other we need to consider the following:
When someone is unable to function in a particular job or situation because of lack of talent, training or health issues, offering help/guidance instead of punishment will be the most effective approach. We sometimes may need to take a look at how and when we can legally take steps to protect both the sick individuals and those who may be directly affected by the person’s inability to function.
There are a minority of individuals without a diagnosable condition who are unable to treat themselves and others with respect. The general label for these individuals is sociopath. No one asked to have their brain function this way. People who are unable to treat others with respect may need to be in a protected environment where behavior is clearly regulated. Even in this situation individuals deserve to be treated with respect.
Written August 18, 2016
A recent conversation and a 2014 Ted talk to which I listened for the 2nd or 3rd time this morning prompted me, one again, to think about the role of rules in my professional and personal life.
The recent conversation occurred because I am in the process of moving and will have to decide if I am going to conduct my greatly reduced psychotherapy practice out of my home or to continue to only interact with client via. phone, face time/skype, email, and text. There are some legitimate concerns about whether I see client in a home office. If one has a home office, then there are insurance concerns in case a client falls or otherwise gets hurt on the premises. Type of insurance also is affected by the amount of expensive office equipment one has. I understand these concerns.
One might think it is simple to decide if one is doing business in one’s home and then make appropriate decisions regarding insurance. This is not always the case. For example, I am moving back to the geographical area where I had a large home psychotherapy practice for a number of years. Many of those who periodically employed me were also colleagues. Thus, I had, what is usually referred to in our profession as dual relationships with many people. One moment they might be there as a colleague or a friend and the next they might be there for clinical consultation in my role as clinical supervisor or they might be there as a client. Sometimes folks who previously were clients stop by to share with me how well they are doing, to ask a brief question or for a “refresher moment”.
There are those individual who very clearly want and need a very specific appointment for “therapy” and/or those who clearly need me to stay in the therapy role any time I see them – even at the local grocery store. Those are limited relationships
I am also 76-year-old which, for some, clearly put me in the role of mentor, elder, substitute uncle or grandfather to whom they come for a listening ear, direction or advice. Some of these may have previously been a client and some may not have been.
When I functioned in a full time psychotherapy practice I had an office manager who often did more therapy/counseling that I did. She was not licensed but she was often the one to whom people talked when they called or while they were waiting to see me. She was a very wise, compassionate person who clients/patients considered an equal member of the healing team. There was a gifted and loving person who helped with cleaning. If she was there when a “client” stopped by they might chat with her. For a time, there was also a psychiatrist who used another office in my home part-time. She talked to my clients and I talked with her patients.
Both the psychiatrist and I are licensed by the states in which we practice We also are members of professional organizations. Each licensing board and professional organization have an ever expanding written code of ethics which attempt to cover every possible scenario between a professional and their clients/patients. These rules are an attempt to clearly define who is a client/patient, the boundaries of the relationship, how to protect confidentiality, and what to do if a professional is abusive or inappropriate. The theory is that professionals cannot be trusted to decide what is ethical and appropriate and that every person and situation can be viewed through the microscope of these many rules. Different professional organizations often have different rules.
Clearly clinicians –therapists, physicians, and others – are sometimes inappropriate. Some live with various additions or other conditions which may not be successfully treated – alcohol, drug, money, power, sex, food and other addictions which may adversely affect their behavior with clients/patients. If the addiction or other illness is in charge, that person cannot be effective in their professional or personal roles. Clients/patients need to be educated about how to fire those individuals. Theoretically they can also report that person to the professional organization so that they can get help. In practice the clinician may be punished rather than helped and/or may be sued for “damages”. Clearly we need to identify and help those clinicians and also sure that clients/patients get the help they need.
I am not convinced that having a very detailed code of ethics is helpful for the clients/patients or the clinicians. There is really only one rule: Keep the needs of the client primary. If one does not have the time, energy, health, or expertise to help a client/patient then one needs to help the client/patient find the type and level of help they need. Most mental health clinicians know that the number of rules does not usually correlate with creative performance for adults or children. Ye, we continue to operate as if that is the case.
We also do the same in the workplace, in schools, in government agencies and business organizations. We seem to begin with the assumption that people of any age cannot be trusted. We spend a lot of energy attempting to prevent sloth, laziness, cheating, or any other way of failing to “behave” appropriately. This brings me to the October 2014 Ted Talk by Ricardo Semier, “How to run a company with (almost) no rules. Mr. Ricardo’s company was/is:
“…a complicated company with thousands of employees, hundreds of millions of dollars of business that makes rocket fuel propellent systems, runs 4,000 ATMs in Brazil, and does income tax preparation for dozens of thousands. So this is not a simple business.”
He and others in the company:
“… said things like, why can't people set their own salaries? What do they need to know? There's only three things you need to know: how much people make inside the company, how much people make somewhere else in a similar business and how much we make in general to see whether we can afford it. So let's give people these three pieces of information. So we started having, in the cafeteria, a computer where you could go in and you could ask what someone spent, how much someone makes, what they make in benefits, what the company makes, what the margins are, and so forth. And this is 25 years ago.”
They let employees decide when to work, what to wear to work, how much they needed to accomplish and many other aspects of their work life. The company thrived. Certainly there are times when a person is unable to do a job or is not a good fit for this atmosphere, but, in general, most people functioned better when treated with respect.
Mr. Ricardo has also successfully worked with schools to basically apply the same principles.
These concepts are also consistent with the theories of such workplace consultants as Margaret Hefferman who talks about the social contract in the workplace as well as with the experience of those who manage Silicon Valley startups companies.
It would seem that if we want to bring out the best in each other we need to consider the following:
- Coercion through rules or other methods do not bring out the best is us humans - in terms of production, creativity or health.
- We can trust each other to do our best most of the time unless some illness or condition hinders us.
- Peers at any age will tend to informally determined what behavior can be tolerated by team members.
- Ownership in the process and outcome will normally determine the extent to which we do our best to achieve a goal. This approach benefits everyone involved.
When someone is unable to function in a particular job or situation because of lack of talent, training or health issues, offering help/guidance instead of punishment will be the most effective approach. We sometimes may need to take a look at how and when we can legally take steps to protect both the sick individuals and those who may be directly affected by the person’s inability to function.
There are a minority of individuals without a diagnosable condition who are unable to treat themselves and others with respect. The general label for these individuals is sociopath. No one asked to have their brain function this way. People who are unable to treat others with respect may need to be in a protected environment where behavior is clearly regulated. Even in this situation individuals deserve to be treated with respect.
Written August 18, 2016
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