Tuesday, November 01, 1994

The Unremembered: Searching for Women at the Holocaust Memorial Museum

by Andrea Dworkin
First published in Ms. magazine, Volume V, Number 3, November/December 1994.

 
In early September 1993 I went to the United States Holocaust Memorial Museum in Washington, D.C., to do research for a book on scapegoating, especially of Jews and women in anti-Semitism and woman hating. In November I went back to the museum because Ms. asked me to write about it. I consider myself not-a-civilian in the world of Holocaust memory, no stranger. A survivor's knowledge of the women's camp and killing center at Auschwitz-Birkenau was passed on to me by an aunt having flashbacks-- graphic, detailed. of rapes, murders, tortures--when I was ten, a child without intellectual defenses. In a tiny room in Camden, New Jersey, I saw what she said was happening--what she was seeing--as she reexperienced her captivity. I still see it. Many of my teachers in Hebrew school were survivors, and they were different from everyone else. In the 1950s, closer to the real events, they lived more there than here: they shook, they cowered, they suffered--beyond understanding, in silence, without explanation. They lived in terror.
 
For me, the Shoah, the Hebrew word for "annihilation," is the root of my resistance to the sadism of rape, the dehumanization of pornography. In my private heart, forever, rape began at Auschwitz; and a species of pornography--sexualized anti-Semitic propaganda--was instrumental in creating the hate. My adult heart knows that Julius Streicher, who joined with Hitler in 1921, was executed at Nuremberg for his part in the genocide of the Jews because he published the rabid, pornographic, Jew-hating tabloid Der Sturmer, which was used by the Nazi party, then Hitler's regime, to fuel aggression against the Jews. Streicher was convicted of committing a crime against humanity.
 
* * *
Inside, the museum building is purposefully uncomfortable to the eye, to consciousness. Prisonlike elements are part of the design: cold, institutional brick walls made colder by exposed steel girders; windows obscured by metal bars or grates or louvered slats. There is a visual eloquence that does not let the mind drift, because the eye cannot find anywhere not prison-inspired to land. The interior, developed by the architect to suggest physical elements of Auschwitz, is ruthless: it demands alertness and suggests both danger and oppression.
 
The permanent exhibition is on three floors of a five-story building. One takes an elevator to the fourth floor: Nazi Assault 1933-1939 (Hitler's ascendance and the German conquest of Europe). The third floor is dedicated to illustrating and explicating the facts of the Final Solution 1940-1944; and the second floor is the Aftermath, 1945 to the present.
 
Standing in line for an elevator, I am encouraged to take a card on which is a photograph of a Holocaust victim, his name, his biography. Other women fingering through the cards ask each other, where are the women? Why aren't there biographies of women? They express a muted outrage--not wanting to call attention to themselves yet unable to accept that among the hundreds of cards there are no women. A museum employee (a woman) explains that the cards of women have all been used. We are supposed to be able to pick a biography of someone like ourselves and, with interactive computer technology, find out what happened to our person at various stages of the exhibit. The card machines were not in use (and have since been discontinued); but the absence of women's lives from the biographies was part of an old program, a familiar invisibility and absence, a simple carelessness to get more cards printed or a more malignant indifference.
 
I went to the United States Holocaust Memorial Museum with questions about women. Where, how, in what numbers, were women raped? Where, how, in what numbers, were women prostituted--the brothels in forced labor and concentration camps, where were they, who were the women, who used them? Where, how, in what numbers, were women used in medical experiments, and with what results? Who were the inmates in Ravensbruck, a camp for women from many occupied countries but that earlier in Hitler's reign held German political prisoners, prostitutes, and lesbians--how did they get there, what happened to them? What exactly was done to Jewish women at Auschwitz-Birkenau or to the Jewish women held at Bergen-Belsen in 1944? How did the hatred of Jews and women intersect, not abstractly but on their bodies? How was the sadism against Jewish women organized, expressed?
 
There were no answers to my questions in the permanent exhibition's story of the rise of Hitler or the genocide of the Jews or the mass murders of the Poles, Gypsies (Roma), and other stigmatized groups; nor in the "aftermath," what happened in Europe when the Nazis were defeated. Although there were films and photographs of women, often naked, terribly brutalized, and there was first-person testimony by women survivors, there was no explanation or narrative of their persecution as women; nor was there any coherent information in the computers in the Wexner Learning Center, intended to be an electronic encyclopedia of the Holocaust; nor in any side exhibits. (One temporary exhibit, for children, is on the fate of a young Jewish boy. Another documents the efforts of a brave male intellectual to rescue mostly male intellectuals from Nazi-dominated France. In both, the romance of male significance mobilizes feelings and attention.)
 
I was given research materials that demonstrated the museum's commitment to documenting the egregious persecution of homosexuals; included were biographies of eight gay men and one lesbian. The museum's first conference--held in December 1993 on "The Known, the Unknown, the Disputed, and the Reexamined"-- eliminated women altogether by disappearing the one lesbian. There were talks at the conference on "Nazi Anti-Homosexual Policies and Their Consequences for Homosexual Men" and "The Pink Triangle: Homosexuals as 'Enemies of the State.'" There was scholarship on "The Black Experience in the Holocaust Period"; but nothing on women--not on Jewish women or Gypsy women or women political prisoners; not on female perpetrators, S.S. volunteers, for instance, some of whom were convicted of war crimes; not on Hitler's social policies on women's reproductive rights; not on the relentless early suppression of the feminist movement in Germany. Women were apparently neither known nor unknown, a common enough condition but no less heartbreaking for that.
 
In the museum, the story of women is missing. Women are conceptually invisible: in the design of the permanent exhibition, by which I mean its purpose, its fundamental meaning; in its conception of the Jewish people. Anti-Semites do not ignore the specific meaning or presence of women, nor how to stigmatize or physically hurt women as such, nor do those who commit genocide forget that to destroy a people, one must destroy the women. So how can this museum, dedicated to memory, forget to say what happened to Jewish women? If this genocide is unique, then what happened to Jewish women was unique; attention must be paid. If not here, where?
 
Genocide is different from war. In a genocide, women and children are primary targets, not accidental victims or occasional combatants. This museum, governed in its narrative choices by a courteous, inclusive politics of sensitivity to ethnic and political persecution, leaves out the story of the Nazis' hatred of women. The role of misogyny in the organized sadism of these men must be articulated: because women's lives were destroyed by careful plan; and because that sadism continues to contaminate and compromise what it means to be human. The Nazi invasion of the human body--the literal and metaphoric castration of subjugated men, the specter of the sexualized, tortured. emaciated "Jewess," mass plundered, mass murdered--is still the touchstone for an apparently depoliticized social sadism, a fetishized rapism that normalizes sexual humiliation and mass dehumanization. Sex tourism is one contemporary example--Thai women and children kept in brothels for the use of male consumers from developed countries.
 
This is what it means to pay attention to the sadism of the Nazis in the context of the Holocaust museum. Germans with disabilities were the first victims of secret, systematic murder--from October 1939 to August 1941 at psychiatric clinics. Groups of 15 to 20 would be gassed in carbon monoxide chambers. In the permanent exhibition, there is a photograph of children being killed by lethal injection, their awful steel beds, the restraints. Behind this photo is another--smoke comes out of the chimney of Hartheim, a storybooklike castle near Linz, one of the clinics.
 
There is a photo of a naked girl, probably adolescent, "mentally handicapped," taken before she was killed. She is standing up, facing the camera, full-frontal, but she does not have the strength to stand on her own--her rib cage is all bones--so a nurse in a conventional white uniform holds her up by force; the pain on the girl's face is horrible. The photograph itself is Nazi child pornography--no breasts, no hips, not enough food for that, no paint or makeup, just a naked body and pure suffering; child pornography for real sadists, those who do not want their victims to smile. And there is a photo of an eight-year-old boy, also "mentally retarded," also naked, also full-frontal, this too child pornography Nazi-style, the camera complicit in the torturer's pride, his monument to memory.
 
Concerning disability, so-called Aryans turned in their own, not a dreaded racial "other." This was the first place where murder could hide behind doctors who would legitimize it. I heard a woman say, "It makes you wonder about Dr. Kevorkian." Yes, it does; and also about oneself--how complicit am I in devaluing those with disabilities, how much fear and prejudice are part of that complicity? I asked myself a lot of hard questions. I was able to ask them because the museum told the story. Those who don't see that pornography is, at its core, the appropriation of another person's body, identity, life, might also begin to have questions.
 
The museum uses words, photographs, documents, films, and artifacts to create a discourse vivid with detail. Archival film and photographs from the period have been transferred to videotape for display. Some exhibits feature photographs mounted on walls. There are more than ten thousand artifacts, ranging from concentration camp uniforms to leaflets confiscated by the Nazis to children's drawings and paintings made during the years 1932-1944. The artifacts are startling, often beautiful. In telling the story of how the Nazis persecuted and murdered the Gypsies, there is a wagon, with a violin. "Yeah, this is the kind of wagon I saw going along the Danube in 1935," said a man behind me. The violin belonged to Miodrag Djordjevic-Tukalia, a Roma musician executed by the Germans in October 1941. Each time a name is attached to an artifact, one is made to remember that everything happened to someone. It is as hard to remember the individuality of the victims as it is to take in the mass nature of the slaughter.
 
There are clothes and ornaments that belonged to Roma women; photographs of Roma prisoners being deported to Poland; and a film of Roma children used in so-called racial research. They are clothed and still vibrant, many smiling. Almost all of the Gypsy children at Auschwitz were killed.
 
Approaching the concentration-camp area, I stop thinking. None of it is unfamiliar to me; but here is a real boxcar used to transport Jews, a real barrack from Auschwitz-Birkenau. Film is not easier. There are films of the mass killings by mobile killing squads: a line of naked women standing in front of an already-dug mass grave, naked women shot, falling, piled on top of each other, ravines filled with misshapen bodies. Months later, this will be what I wish I had not seen.
 
Before one enters the boxcar, there are artifacts from the Warsaw Ghetto Uprising, Passover 1943: a 1929 Mauser rifle, fuses for the two unused Molotov cocktails, two 75mm artillery shells, a pistol. Near the boxcar, to its side, is a workbench that concealed a hiding place for Polish Jews in the house of Stefan Petri near Warsaw; a handcart used to transport heavy loads and dead bodies in the ghetto; a manhole cover, from Warsaw, because Jews hid in the sewers.
 
There is a wall of photographs of Jews and Gypsies being deported, from internment camps and ghettos to concentration camps and killing centers; still photos of the trains that transported them, all preface to the actual boxcar. Now one must choose to walk through it or around it. The boxcar is set up this way so that Holocaust survivors do not have to walk through it.
 
The freight car is clean now. I wonder if they had to scrub it out. It is smaller than I could have imagined. It is dark inside. There is nowhere to sit. Aunts and uncles and cousins of mine were here.
 
There is a wrought-iron gate to a camp, with its wrought-iron arch, Arbeit Macht Frei ("Freedom Through Labor"). In front of it are piles of things taken from the victims: scissors, can openers, strainers, graters, mirrors, toothbrushes, razors, clothes, hangers, hairbrushes, shoe brushes, knives, forks, spoons; and a photo of confiscated suitcases, duffel bags, prayer shawls, canes, leg braces, and artificial limbs. One walks under the arch--through the gate--to a real barrack from Auschwitz-Birkenau, one of the more than 200. This barrack held Jews from Theresienstadt Ghetto in Czechoslovakia.
 
There are benches to sit on, before going in. I sit. The bench is peaceful, the floor a hard, smooth, shiny stone surface with lovely pastels in it. Then I see the identification of the very floor under my feet: "A path connecting Treblinka killing center with a nearby forced labor camp was paved with the crushed remains of tombstones from Jewish cemeteries. Below is a casting from a section of the path; Hebrew letters are visible in several pieces." Behind me there is sound: a glass-enclosed room, also with benches, with photos of the physical plant at Auschwitz-Birkenau, and from speakers in the floor come the voices of survivors of Auschwitz saying what happened to them there, the small details of degradation, narratives of humiliation, torture, and overwhelming loss. I walk on the casting of the crushed tombstones from Treblinka into the Auschwitz-Birkenau barrack where, had I been born earlier, I might have been with the majority of my family on both sides. The bunks are wood, almost slats--but then, they didn't have to bear much weight, did they? I have seen photos with the inmates stacked-in lying flat, but the eye plays a trick: one thinks the bunks must have been bigger to hold so many. There is no smell. This too must have been scrubbed down.
 
In the center of the barrack; are cement walls about four feet high behind which are video displays of some of the medical experiments: photos of dismembered bodies and of bodies and body parts preserved in vats: films of skeletal boys used in medical experiments by Dr. Josef Mengele, known in Auschwitz as "the Angel of Death"; photos of skeletal girls with bruises and open sores all over them. There is a Ravensbruck woman; a single man at Dachau being used for experiments at extremes of air pressure; a Gypsy man being injected with seawater right into his heart; a Jewish dwarf who was subsequently stabbed to death to study his bone structure; a Jewish woman used in sterilization experiments. The low walls are supposed to conceal these videos from children.
 
There are bowls the prisoners ate from; Zyklon B canisters that were used in Auschwitz-Birkenau and Majdanek; a scale model of Crematorium 11 at Auschwitz-Birkenau that shows how vast it was, and also where the victims undressed, were gassed, were cremated.
 
You pass an exhibit on why the U.S. War Department, when bombing military targets only five miles away, refused to bomb the train tracks to Auschwitz to stop delivery of Jews. Though Jewish groups in the U.S. repeatedly begged for this bombing, Assistant Secretary of War John J. McCloy said it "would be of such doubtful efficacy that it would not warrant the use of our resources." You pass through a steel passageway with a glass floor and the names of victims etched in glass panels on the walls. You move into an area with brick walls and a steel floor. You round a corner and there is a smell, strange and bad, thick and heavy, almost suffocating. But you walk onward and then on each side of you there are shoes, thousands of shoes; to your left and your right, the shoes of the dead brought from Auschwitz to be on exhibit here. "We are the shoes, we are the last witnesses," says a poem by Yiddish poet Moses Schulstein inscribed on a wall. It is almost unbearable. Then there is a wall of photographs--just arms with tattooed numbers. The arms face a wall with smaller photographs of emaciated prisoners.
 
Covering another wall there is a huge color photograph of the hair they cut off the women at Auschwitz, a mountain of human hair; adjacent to it, a black and white photo of this hair as it was baled for sale. Facing the mountain of hair are photographs of Hungarian Jewish women with their heads shorn. There is a casting of a table on which gold fillings were removed from corpses: castings of crematorium ovens from Mauthausen; a stretcher used to move bodies, a crematorium poker.
 
When the war ended in 1945, two thirds of Europe's Jews had been murdered. According to Deborah Dwork in Children with a Star, "a mere 11 percent of European Jewish children alive in 1939 survived the war; one and a half million were killed."
 
The museum honors the "Rescuers," those who tried to save Jewish lives: a whole village, Le Chambon-sur-Lignon, in France, that saved 5,000 refugees, including several thousand Jews (the Bible of its pastor, Andre Trocme, is on display); Raoul Wallenberg, a Swedish diplomat who worked relentlessly to rescue the Jews of Budapest; an underground Polish group code-named Zegota that provided money, false identity papers, and hiding places for 4,000 Jews; and the Danes, who refused en masse to collaborate with the Nazis. On display is a boat used by the Danes to smuggle Jews to safety in Sweden. According to the museum, "Among the Nazi-occupied countries, only Denmark rescued its Jews." The Danes raised over $600,000 to help the hunted escape; 7,220 Jews were saved; nearly 500 were deported to Theresienstadt Ghetto--and all but 51 survived.
 
And there are sadder stories of resistance. In Lidice, Czechoslovakia, on May 27, 1942, Reinhard Heydrich, former chief of Reich security police, an architect of the genocide, was shot (he died later). In retaliation, all the male villagers were murdered, the women sent to concentration camps, the children jailed in Lodz Ghetto or, if blond enough, put in German homes. The two Czech resistance fighters who killed Heydrich committed suicide rather than surrender. The Nazis, never camera-shy, photographed the executions of the villagers.
There were 32 parachutists trained by the British in Palestine and sent to Hungary and the Balkans as saboteurs. These fighters also wanted to rescue Jews under German occupation. None was more committed to this cause than the poet Hannah Senesh, a Zionist who emigrated from Hungary to Palestine as a teenager. Commissioned as an officer in the British Army, she fought in Yugoslavia with the resistance. On crossing the border into Hungary, Senesh was arrested by the Nazis as an enemy soldier and jailed by the Gestapo in a military prison in Budapest. The Nazis also jailed her mother, Catherine Senesh, who was still living in Hungary, in the same prison, and threatened Hannah with the torture and killing of her mother. But it was Hannah, who never broke, whom they tortured and, after five months, executed on November 7, 1944. Her last poem read in part: "I could have been twenty-three next July;/I gambled on what mattered most,/The dice were cast. I lost." The museum displays her words but does not tell her story.
 
There was the White Rose, students identified by the museum as the only German group to demonstrate and leaflet against the genocide of the Jews. The leaders, Sophie and Hans Scholl, sister and brother, were beheaded in 1943. (I keep a remembrance of them--an enamel white rose raised on a background of black and gray beads--in front of the German editions of my books.)
 
The permanent exhibition ends in an open amphitheater, on the screen survivors, in good health, strong, fleshy, spirited, with stories of agony and unexpected uplift. They speak with calm and authority, only one with the constant nervous tremble I remember in survivors when I was a child. This is a triumph: to have forged a way of telling. It is impossible to overestimate how hard this must have been. The Nuremberg trials, the historians, gave the survivors some ground on which to stand; but they had to find both words and the will to speak. Many overcame their shame--the internalized humiliation of anyone so debased, in captivity. But many have not spoken, maybe because here too men have established the standard for what can be said.
 
In the last two decades, feminists have learned how to talk with raped, prostituted, and tortured women--what they need to be able to speak, how to listen to them. This museum was in formation for the second of those two decades, a ten-year period of research, investigation, discovery--finding artifacts, deciding which to use and how, which stories to tell and how. No use was made of feminist work on sexual abuse or bodily invasion and violation--neither the substance of this knowledge nor the strategies used to create the safety in which women can bear remembering. I know Holocaust survivors who have not spoken out: women who were raped or sexually hurt. This museum did not become a safe place for women's testimony about the sadism of sexualized assault. One rationale for building it was that soon the survivors would pass on, and the burden of memory would be passed from them to all the rest of us. But because the museum did not pay attention to women as a distinct constituency with distinct experience, what women cannot bear to remember will die with them; what happened will die with them. This is a tragedy for Jews and for women, with miserable consequences for Jewish women. The conceptual invisibility of Jewish women is the kind of erasure that is used--indefensibly, with a prejudiced illogic of its own--to justify yet another generation of second-class status for women in Jewish communities and in Israel. The torment of women in the Holocaust was not second-class, and it cannot translate into second-class rights. Acknowledgment and respect are necessary; the conceptually invisible have neither.
 
Perhaps the threat of seeking this knowledge is that some of the sadism is familiar, even familial; not confined to camps or genocide. Better to avoid any crime against women that men who are not Nazis still commit. Or perhaps women are conceptually invisible because of the continuing and belligerent sexism of the men w ho run Jewish institutions now--but the blinding arrogance of sexism has no place in this museum. I want the suffering and endurance of women--Jewish or not Jewish, in Auschwitz or Ravensbruck, Bergen-Belsen or Dachau, Majdanek or Sobibor--reckoned with and honored: remembered. I want the rapes documented, the brothels delineated, the summary murders of pregnant women discussed. I want the medical experiments--excision of genitals, injections into the uterus--explained, exposed. I want the humiliation rituals--forced nakedness, cutting and shaving of hair, punishments of hundreds or thousands of women standing naked in the cold for 12 hours at a time--articulated. I want the beatings, the whippings, the forced hard labor and slave labor, narrated. I need to know about those who resisted and those who escaped; there were some. I need a heritage on the female side. I want this museum changed so that remembrance is not male. I want to know the story of women in the Holocaust.

Wednesday, October 12, 1994

Rating Your Psychotherapist: What is Psychotherapy and how do I know if I'm in it

© (1994) by Thomas A. Grugle, M.D.


Thomas A. Grugle, M.D.
Psychiatrists and other mental health professionals perform a variety of procedures from psychological testing to writing reports, so just because you're seeing a psychiatrist or psychologist doesn't mean you are in psychotherapy.

Psychotherapy is a psychological treatment intended to help the patient resolve emotional difficulties through a relationship with a professional, the psychotherapist. The psychotherapist is specially trained and (we hope)
gifted in establishing and maintaining healthy, therapeutic relationships with people. However, psychotherapists are not all well trained, and some are just plain sick themselves. It is important, therefore, for the patient to have a pretty good idea of what kind of treatment to expect when beginning psychotherapy.

Psychotherapy occurs one to three times per week in a therapist's office in a face to face seating arrangement. Sessions usually last forty five minutes to  an hour. Psychoanalysis is a more intense form of psychotherapy and occurs four to five times per week over several years. A patient in psychoanalysis will usually lie on a coach so he or she cannot easily see the psychoanalyst. Patients in psychotherapy should never be asked to lie on a couch.

What kinds of psychotherapy are there?

The therapeutic relationship can take place in a variety of settings. Most familiar to the public is individual psychotherapy, where the patient and therapist sit facing one another and talk about the patient's problems. Group
psychotherapy involves a therapist (sometimes two) and a group of patients, usually from five to eight per group. Family psychotherapy (including marital psychotherapy) involves the therapist with the entire family or couple, all
sitting face to face.

What other kinds of psychiatric treatments are there?

Distinct from psychotherapy, medication management by a psychiatrist involves the prescribing and supervision of medication. This may be done in conjunction with psychotherapy or done separate from it. Medication is almost always more effective when combined with psychotherapy, so if your psychiatrist is only prescribing medication and hasn't recommended psychotherapy you should find out why. Medication management sessions are usually much shorter and less frequent than psychotherapy, usually lasting fifteen to thirty minutes and occurring every two to twelve weeks, depending on the patient's symptoms. The rating system below does not generally apply to psychiatrists who only prescribe medication, although many of the points will be important to observe.

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The Rating Scales

Circle the choice that most closely matches your experience with your
therapist.

The First Contact

1. When I called for me first appointment, the therapist called me back the same day, asked briefly about my problems, then offered to set up a first appointment.

2. When I called for me first appointment I spoke with a secretary who asked me for insurance information, then gave me my appointment time.

3. When I called for me first appointment I got an answering machine, the therapist didn't call me back for several days, and never asked me what was bothering me.

4. When I called for me first appointment the therapist told me about his own problems and how he'd resolved them, then offered to see me for therapy.



The First Session

The waiting Room

1. The waiting room was private, quiet and tastefully furnished. I was alone until my therapist came for me.

2. The waiting room was basically neat. I waited with other patients, but it still felt comfortable and private.

3. The waiting room was a bit cluttered. The receptionist engaged me in a conversation while I was waiting. I could hear some talking behind the door to the offices.

4. There really wasn't a waiting room, I had to wait in a public area with other people. Business was being conducted in my view and I was bothered by noises from within and without the office.


The wait

1. My therapist was right on time to get me.

2. My therapist was a few minutes late.

3. My therapist was more than five minutes late.

4. My therapist was more than fifteen minutes late.


The therapist

1. When my therapist came to get me, he greeted me kindly and showed me to his office. He shook my hand briefly and did not call me by name if other people were in the area. We walked in silence to the office.

2. When my therapist came to get me he called my name out loud, then escorted me back to his office. He chatted with me on the way back.

3. My therapist offered me something to eat or drink before we went into the office.

4. A secretary called me back to the therapist's office, or I saw a nurse or assistant before I talked to the therapist.


The session

1. During the first session, my therapist listened carefully and helped me to discuss almost all of the major problems I'd been having.

2. My therapist took notes during the whole first session.

3. I felt disorganized and confused, and my therapist didn't help me straighten things out

4. My therapist told me things about himself and his struggles during the first session.



The close

1. For the last ten minutes of our first session, the therapist briefly summarized my problems and told me what she thought she could do to help. If psychotherapy was recommended it was recommended unequivocally. She told me
how to reach her in an emergency.

2. The therapist said she thought therapy might help and offered to meet again.

3. The end of the session seemed abrupt and I wasn't quite clear what the therapist thought I needed.

4. The therapist gave me a hug at the end and said we should meet again. She said to call anytime if I wanted to talk on the phone.



The Ground Rules


Financial

1. I am totally financially responsible for all charges and my therapist expects me to keep my bill current.

2. Someone else, or an insurance company, pays part of my bill, but my therapist holds me responsible for my portion.

3. My therapist allows me to leave my bill unpaid for several months.

4. My therapist offered to creatively bill my sessions to my insurance company so that I wouldn't have any out of pocket expense.



Appointments

1. I have a regularly scheduled time to meet for therapy, the same time each week.

2. I have sessions every other week and schedule as my time allows.

3. I often have extra sessions if I'm having a rough week.

4. It's hard to get regular appointments because of my therapist's schedule.



Missed Sessions

1. If I miss an appointment, no matter what the reason, I am still charged for that time.

2. If I cancel more than twenty four hours in advance I am not charged.

3. If I miss a session my therapist still bills the insurance company.

4. I'm not sure what happens if I miss.


Therapy Goals

1. I have a clear understanding of what my goals are and how long it might take to achieve them.

2. I basically understand what I'm working on, but we've never discussed treatment length.

3. My therapist told me we would finish within ten to thirty sessions.

4. My therapist says I will need her forever.



Confidentiality

1. If someone calls about me without my prior consent, my therapist doesn't return the call and tells me about it at the next session.

2. My therapist has called someone in my family to discuss me.

3. My therapist has written an article about our sessions without my consent.

4. My therapist has videotaped our sessions and I'm not sure what he does with the tapes.



Therapist Activity

1. My therapist sits quietly during most of the session, speaking only to help me keep going if I get stuck or to observe something I was about to see myself anyway.

2. My therapist talks about half the time.

3. My therapist talks more than half the time.

4. Sometimes my therapist talks the whole session.



Material

1. I talk about whatever comes to my mind without censoring or changing it in any way. My therapist encourages me to do so, especially if I am having thoughts or feelings about her.

2. I talk mainly about my current life and almost never mention dreams or
fantasies.

3. I talk about current events and politics.

4. I talk about my therapist almost all the time (when I get to talk).



Fringe Techniques

1. My therapist has never suggested hypnosis, sodium amytal, or anything other than talking in the office.

2. We occasionally take walks outside the office to talk or we meet some other neutral place.

3. My therapist suggested hypnosis, age regression, sodium amytal, channeling, or body work.

4. My therapist actually did hypnosis, age regression, sodium amytal, channeling, or body work.



Boundary Violations

The Setting

1. We never meet anywhere but the office.

2. We have taken a walk or met in some other office.

3. We have met in my therapist's home.

4. We have met in my home.



Physical Contact

1. My therapist never touches me at all.

2. We shake hands after each session.

3. We hug after each session.

4. We have had sex together.



Personal Information
1. I know nothing about my therapist except his professional credentials and marital status.

2. I know where my therapist lives and how many kids he has.

3. My therapist has told me about his marriage or childhood.

4. My therapist has shared a great deal about his own personal struggles.



Time Management

1. We always start on time and end on time.

2. We occasionally start five or ten minutes late, but still end after the allotted time.

3. We sometimes start thirty to sixty minutes late and often run over more than five minutes.

4. Its hard to know when we'll start or finish-it could be off by a much asan hour or two.


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Scoring

Add up the points for each question to arrive at your total score.

IMPORTANT NOTE- If you scored any question as a 4 you are in potential danger from this therapist and it is highly recommended that you seek immediate consultation from a board certified psychiatrist.


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18 - 27
Congratulations! You have selected a psychotherapist who seems well trained and competent. There are no serious problems that should worry you and if issues do arise they are probably talked about openly.


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28 - 45
Your therapist is basically doing a good job, but occasionally engages in activities or behavior that might impede your progress in psychotherapy. If you are concerned, seek consultation from another qualified professional about your psychotherapy and how its going.


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46 - 63

This score indicates a seriously impaired psychotherapy. It is doubtful that any therapy is going on at all. You are strongly encouraged to consider seeking consultation from a board certified psychiatrist and ending your treatment with your current therapist.


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64 - 72

You may be in serious danger from this relationship. Boundary violations and errors in technique abound. You are advised to seek immediate consultation from a board certified psychiatrist and seriously consider not returning to
your current psychotherapist at all.


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Psychotherapy is an effective and safe treatment when properly administered. There is much room for differences in style, but no room for errors in technique. The issues that have been presented in this article address errors in technique. Most competent psychotherapists do occasionally engage in behaviors or techniques that have been rated a "2" in this article. When they do, they always have clear and well thought out reasons for doing so and can explain why these minor variations in technique are in the patient's best interest.

One of the most important indicators of a good therapeutic relationship is your own feelings. If you don't feel quite right about what's happening in your therapy, get a consultation. You may wind up spending time and money only to find out things are going the way they are supposed to, but you may also save yourself from continuing in a damaging therapy relationship.