With trepidation...

Not sure where I'm going with this, so I will just write and see..

Someone pointed me in the direction of Kendra, a woman who posted a succession of films about falling in love with her psychiatrist.

I've only watched two YouTubes about her story so far - one from an expert in AI who was commenting mostly on how the 'magic mirror' quality of LLMs can reinforce error, as Kendra took to talking to two AIs about what happened. And the other YouTube is from a Dr in Seattle. 

Briefly, the complaint Kendra makes against her psychiatrist is that he had feelings for her, and so he 'bread crumbed' her into staying in therapy with him for four years. 

This would be incredibly difficult to determine!

But I think that a question about intentions is missing out something vital. What if all the usual questions about boundaries and ethical conduct fall away because the criteria used to identify a problem simply doesn't fit what happened?

What If the psychiatrist acted in the best and most ethical way and despite all good intentions the outcome was more hurt and harm to Kendra?

What if everything was right?

So, what went wrong?

Should we dismiss Kendra's version? She felt that harm occured. So we must ask what is the problem with the interpretation of ethical behaviour, in therapy?

The assessments about wrong doing made by the people in the videos, focused on only two questions:

1. Was Kendra deluded or not - Blame the client.
2. Was the psychiatrist's behaviour ethical or not - Blame the therapist.

They are reasonable questions and yet, as I try to understand this story I keep hearing this phrase in my mind, the operation was a success but the patient died.

The only things I am sure of is that:

1. Kendra states that she experienced "weaponized neutrality".. 

The Dr in Seattle didn't accept Kendra's term: weaponized neutrality. Because neutrality is neither good nor bad and harmless. Well nitrogen is relatively neutral. We breathe it in all the time, we live within it every day. If there wasn't oxygen in the mix, we would die.

Oxygen isn't neutral.

Deep sea divers will suffer lethal agony from the very same nitrogen unless they abide by decomposition protocols.

The only thing the Dr was concerned about was physical contact. Physical reactivity or physical neutrality. My argument is that Eros, like neutrality makes itself felt, like nitrogen bubbles in the blood as a diver suffers from the bends! Neutrality is a performance favoured by those of a psychodynamic modality in particular. 

Neutrality is an important part of therapy though, it can be a stance (performance) or an act of self moderation. When it comes from authenticity we weigh up multiple possibilities of the client's meanings, and settle on a use of words and  body language in reply to a perception that a client is asking us to go into 'danger'. We trust that our reply is going to be the smoothest, safest for all.

But...

Epistemic injustice: neutrality can be a withholding of information purposefully and intentionally, to maintain an unequal power dynamic. 

Epistemic injustice destroys informed consent. Hence Kendra's view that her psychiatrist was withholding information to keep her hooked and paying him. 

If Kendra's psychiatrist was fearful of his feelings and chose to avoid the truth, then he was enacting his preferred version of reality and denying hers. A performance. 

And as she couldn't tell what was actually going on, she kept paying him.

People associate the term catfishing with complex narratives designed to create an alternative reality.

The person doing the catfishing spins a web of half truths and lies withholding critical information to keep the victim swimming, trying, trying harder to get to the truth, trying, trying harder in this case, to prove what a good match they are, trying, trying so hard to make something meaningful out of some gesture or word that could be interpreted as significant if the ambiguous hoped for context is true. 

Then when it is all over, having been so powerless it feels safer to tell ourselves that all the uncomfortable details don't matter. 

Self blaming, self attack often follow.

In my case, Kit's refusal to talk about his feelings, and indeed blushing when I asked him directly to be more open with me, certainly didn't do me any good! As much as I understand the constraints of the profession, at some point there needs to be more openness about the fact that therapy techniques such as neutrality,  act at times in the same way as a prejudicial denying of information.