Article on Anne Sexton and her psychiatrist

[Dr. Richard Grossman]

Hi everybody,

There's an interesting article/interview by Ruth Graham in today's Boston Globe on Anne Sexton and her psychiatrist, Martin Orne.  The sessions were recorded, and only one previous biography on Sexton in 1991 by Diane Wood Middlebrook made use of the tapes.  Here's the link:

"What Anne Sexton told her psychiatrist
A new book mines the poet’s confidential therapy tapes. Author Dawn Skorczewski of Brandeis University explains why."

http://www.bostonglobe.com/ideas/2012/03/24/what-anne-sexton-told-her-psychiatrist/sbNcF9CdZGu9yyHdF6BBuL/story.html


Here's one of the lines from the interview with Skorczewski (the author of the new book):

"In one of their final sessions before Orne left Boston, Sexton...says in essence, that’s what we did, we gave birth to me: “the discovery of a human being.”"

Comments?

Richard

[BonesMS]

I have HUGE mixed feelings about this as I can look at both sides of the coin.  Based on what I learned in school about professional ethics, I don't feel that it was appropriate for Orne to make these tapes of their treatment sessions public, regardless of the fact that the client committed suicide.  The Code of Ethics, as I understand them, state that once a client, always a client and that the cloak of confidentiality must remain in place.  How would anyone feel if their therapists published their comments, posthumously, in order to make money off of selling a book?  I am NOT comfortable with it at all!!!

Then to make matters worse, the NEXT therapist has a sexual relationship with his client, which is CLEARLY a violation of Professional Ethics!!!!!  The power differential puts the therapist at an advantage and the client at a DISADVANTAGE.  In my opinion, for what it's worth, any therapist who has sex with a client is committing professional rape!  I think that might have been a factor in Sexton's decision to end her life as the second therapist dismantled whatever progress the client and her first therapist accomplished.  WHAT was the second therapist THINKING when he started having sex with her?!?!?!?  Did he EVER think of the phrase:  "First, do NO harm?!?!?"  Clearly not!  He was simply thinking with a different part of his anatomy!

Now if Orne had simply changed the name of his client, to protect confidentiality, but used the situation as a teaching tool in a textbook, (which I've read in my graduate school textbooks), then I can understand.  I DON'T understand the ripping away of the cloak of confidentiality.

Bones

[sKePTiKal]

Well, the goal of therapy - from the client's point of view anyway - is to discover the human being that they are, right? Get comfortable with that human. Like that human... and learn to take care of that being in healthy ways.

I (OK, those were the Twiggy-days) remember Anne Sexton (and Sylvia Plath) and how they made the news. In some ways, they shattered some myths about women in the mainstream consciousness. Broke ground on topics that previously were "unmentionable" in "polite society" and they exposed themselves mercilessly in the process. There was a lot of negative judgement levied against their work (outside of certain academic circles). That took the most extraordinary amount of courage.

Several of us keep coming back to the idea of publishing - in one form or another - our stories. Some of us even have published... or written screen-plays... or... we've most definitely "published", albeit semi-publicly, here. It is important to tell our stories. Not just as a method of healing, but for others. The first time I discovered this site... and read some of the posts... the sense of recognition of people who had something in common with my own struggles got me hooked and addicted almost immediately. That "being a member of..."  - connection - belonging... absolutely filled a deep longing I uncovered in my own therapy. I'm still learning; still fixing that.

It sounds from the snippets of tape that was reported, that Anne would've benefited from directly sharing her story and surely "gave permission" in the statements that "if it could help someone else"... they could be used/published... and it would appear, though of course I haven't read the book yet, that the tapes are more background material informing the biography... than lengthy direct transcripts of therapy sessions. So it's an unusual exception to the strict adherence to confidentiality, for sure. But that's beside the point of the question you asked Dr. G...

"the discovery of a human being" - pretty much sums up what "it" is all about, doesn't it? And the "it" can be defined as a lot of different things.

No better, no worse... than any other human being. Most of us. (I haven't made up my mind yet as to whether truly saintly or evil people exist; or whether it's only their actions & intents that are definitely evil... it doesn't seem too important to my way of understanding people, the world & life).

[BonesMS]

I guess my feeling is that Anne Sexton did NOT sign any release forms giving permission to have any parts of her therapy sessions published and disclosing her name as the identified patient.  Her death does not give automatic permission to ignore the cloak of confidentiality.

I think the reason I feel so strongly about this is because, in a sense, I'm in a similar situation to Dr. Orne even though I don't have any recordings of the sessions I had with a famous client.  I had to confront people when they attempted to take pictures of this client, at the treatment facility, DURING the treatment period!  Needless to say, I didn't make any friends and it was probably a factor in my getting fired less than a year later because I didn't cater to fame and treat the famous client with deference, give special exceptions to the house rules, placing on pedestal, worshiping, etc.  I countered that by feeding ANY part of the addiction, we would be accomplices in the client's death!  I felt that the catering, fawning, etc., etc. fed into the addiction process.  When the "supply" was not there, then the self-medicating would escalate and the vicious cycle would repeat itself.  When that client passes away in the future, I still won't have permission to publish anything about that client.

I don't know if I'm making any sense trying to describe the pictures I'm seeing in my mind.

Bones 

[JustKathy]

How would anyone feel if their therapists published their comments, posthumously, in order to make money off of selling a book?  I am NOT comfortable with it at all!!!

I'm not comfortable with it either. When I share my private thoughts with my therapist, I expect them to remain that way. If I passed away, and my therapist wanted to use the content of our sessions anonymously for educational purposes, that's fine, and something I would be on board with as it might help other victims. I would NOT want my name attached to it, though. Using a famous person's name for profit is most definitely wrong. I actually see this is as being potentially dangerous. What if a celebrity who desperately needs help decides against seeing a psychiatrist out of confidentially concerns? The consequences could be dire.

[BonesMS]

How would anyone feel if their therapists published their comments, posthumously, in order to make money off of selling a book?  I am NOT comfortable with it at all!!!

I'm not comfortable with it either. When I share my private thoughts with my therapist, I expect them to remain that way. If I passed away, and my therapist wanted to use the context of our sessions anonymously for educational purposes, that's fine, and something I would be on board with as it might help other victims. I would NOT want my name attached to it, though. Using a famous person's name for profit is most definitely wrong. I actually see this is as being potentially dangerous. What if a celebrity who desperately needs help decides against seeing a psychiatrist out of confidentially concerns? The consequences could be dire.

I agree!!!

The consequences could be DEADLY!

Bones

[teartracks]

It appears that Orne chose to put a contemporaneous 'spin' on his professional relationship Anne Sexton.
I expect the world of psychiatry (and folks like us) will choose sides and discuss why they think it was legal, illegal, good, bad, beneficial or not until the cows come home.  Personally, I am in favor of strict adherence to confidentiality.  If I were choosing a psychiatrist, I'd try to get their opinion of Dr. Orne's action.  After that, I'd evaluate whether their answer had a thick veil of fairy dust on it.    Always a skeptic... 

tt

[BonesMS]

It appears that Orne chose to put a contemporaneous 'spin' on his professional relationship Anne Sexton.
I expect the world of psychiatry (and folks like us) will choose sides and discuss why they think it was legal, illegal, good, bad, beneficial or not until the cows come home.  Personally, I am in favor of strict adherence to confidentiality.  If I were choosing a psychiatrist, I'd try to get their opinion of Dr. Orne's action.  After that, I'd evaluate whether their answer had a thick veil of fairy dust on it.    Always a skeptic... 

tt

I agree, TT.

The Mental Health Profession has a WRITTEN Code of Ethics for a reason and psychiatrists SHOULD KNOW BETTER than to violate that Code!  Violators can and do lose their licenses to practice.

Bones

[sKePTiKal]

tt - let me toss a poet's name into that same "should read" category of intensity - Mary Oliver. My T recommended her to me and while it repelled me to dive right into those emotions... it was the right thing for me to do, at the time. If you google her name, you'll find a fair number of poems online. It's sorta like being sandblasted - hurts like hell during; but you're smoother and squeekier clean afterward.

[KayZee]

Oh, P.R.  I couldn't agree more.  I've always loved Mary Oliver.  So therapeutic.  And often so beautiful it hurts.  

Below is one of my eternal favorites.  Something in it has always just spoken to me.  Probably,  the suggestion that just being myself, having my own wants/needs/desires (i.e. being an entity separate from my NM) is not something I have to spend the rest of my life apologizing for and repenting over.  Plus, the fact that even though I don't have a real place in my FOO doesn't mean I don't have a "place" in the world--in the cosmic "family." - Kay x

You do not have to be good.
You do not have to walk on your knees
For a hundred miles through the desert, repenting.
You only have to let the soft animal of your body
love what it loves.
Tell me about your despair, yours, and I will tell you mine.
Meanwhile the world goes on.
Meanwhile the sun and the clear pebbles of the rain
are moving across the landscapes,
over the prairies and the deep trees,
the mountains and the rivers.
Meanwhile the wild geese, high in the clean blue air,
are heading home again.
Whoever you are, no matter how lonely,
the world offers itself to your imagination,
calls to you like the wild geese, harsh and exciting --
over and over announcing your place
in the family of things.

- Mary Oliver, "Wild Geese."

[KayZee]

Lord, I got so lost in my Mary Oliver reverie there, I forgot to say. . . I would be posthumously horrified if any therapist of mine ever broke my confidence and published notes from our sessions.  That said, I am fascinated/horrified/awed by Anne Sexton (who has always seemed like an NM herself) and devour anything that sheds more light on her character and her family.  Totally hypocritical, but there you go!  Kay x

[sKePTiKal]

Kay, I like the Wild Geese too - for the same reasons! 
Also I hear a booming quietude in her phrasing and words... a place to just unfurl what does exist of myself and stretch my wings.

[river]

But apart from publishing what was within the sanctuary of a one one conversation, theres a picture of
Dawn Skorczewsk with a beaming smile sitting on Anne Sexton's grave wearing shorts ~ wheres that at? 

river

[Meh]

Anne killed herself. Nobody helped her. They took her money and now are trying to make more money off of her.

Using and exploiting the mentally ill? Or riding on the waves of celebrity.
I would have to read the books to understand the tone of what is transmitted. It sounds as if it is more about Anne's character rather than the disease of alcoholism or the illness of manic-depressive/bipolar. I ask myself: are there other ways to learn about alcoholism/bipolar disorder and child abuse?--yep there are other ways, we don't need to read Anne's personal business.

I'm sure that there are Manic Depressive/alcoholic patients willingly enrolled in research studies that are producing information for psychology students to read. BUT I guess that wouldn't be a very profitable book?

Anne wasn't a research subject and even if she had been it would be outdated by now.

1963 and 1964 are pretty old dates to refer back to if one wants to study therapeutic technique for the purpose of healing people....well I would begin with more modern reference I would hope. How can this possibly even contribute to current psychology? I hope there have been advances in psychology since 1964. Would you go to a doctor that hadn't learned anything new since 1964?
This is 2012. I mean lobotomies stopped around 1961 or something? Are we going to start lobotomy again?

We have Sinead O'Conner being interviewed by Oprah! Sinead has been pretty open and I've heard a lot of jokes made about her- that is how far we have come with society accepting bipolar as a legit medical issue. It's the freak-o-meter that makes Anne Sexton readable.

Ann Sexton is a historical figure and maybe she is some sort of archetype:
The hysterical-creative-dysfunctional-sick-female
The bad mother
The failed female/housewife in a 60's dress and hairdo

It also promotes the stereotype between creativity and mental illness. It has been pointed out that sane creatives are not celebrated for their sanity.

If Anne was so loopy she probably wasn't really legally capable of giving consent anyways.

"The interests of the nation transcend those of the individual":
http://www.nejm.org/doi/full/10.1056/NEJM199205143262017

Why is a mentally ill female more interesting then an erectile dysfunction male? Why isn't a man's erectile dysfunction "the interest of the nation"?

Well the whole nation wants to know about America's Idol and dancing with the stars....should we release their medical records also??

Why is Anne so important that she has become an interest to the nation?? Geeze

Um, part of the problem is that a therapy session is a business transaction. The patient purchases a service. So the therapist is sort of the temporary employee of the patient somehow. I don't think at any point the therapist should be able to decide that the information is going to be given out for mass publication. I wonder if Orne was paid money by the author for the info?
There is some kind of arrogance in it, medical professionals see themselves as the authority figures that is why the therapist thought it was his right to make the decision to release the info?

Famous people these days probably make their therapists sign extra contracts written up by personal lawyers.

I'm still going on about this....what can the average lay person know about somebody that was an abuser and abused, was mentally ill and a substance abuse user? I don't think there is anything the average reader can learn.

There was a statement I read that said the therapist caused her to write the poetry--enabled her to write the poetry. Almost as if the therapist was responsible for it!