Pathological altruism

When helping ends up hurting
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A recent New York Times article* reviewed a subject that is beginning to gain credibility in the psychological sciences, pathological altruism.

Natalie Angier reports how Dr Robert Burton, author of On Being Certain and A Skeptic’s Guide to the Mind, saw an oncology colleague’s “zeal to heal could border of fanaticism, and how his determination to help his patients at all costs could perversely end up hurting them.” Burton says “If you’re supremely confident of your skills, and if you’re certain that what you’re doing is for the good of your patients, it can be very difficult to know on your own when you’re veering into dangerous territory.”

A new book called, unsurprisingly, Pathological Altruism is according to Angier “the first comprehensive treatment of the idea that when ostensibly generous ‘how can I help you?’ behavior is taken to extremes, misapplied or stridently rhapsodized, it can become unhelpful, unproductive and even destructive.”

Interestingly, Barbara Oakley, editor of the book said that when she first started talking about pathological altruism at conferences “people looked at me as though I’d just grown goat horns.” Oakley suggests this “epitomized the idea ‘I know how to do the right thing, and when I decide to do the right thing it can never be called pathological’.”

The article is a timely contribution to the debate I have been having with Steve Andreas, Nick Kemp and others about how facilitators know when what they are doing is not working (see Calibrating whether what you are doing is working).

Many years ago Shelle Rose Charvet coined her own term for people who are overly keen to help, she called it ‘healitis’. Eric Berne’s brilliant Games People Play has a description of a game called ‘I’m only trying to help’.  In it the would-be Rescuer becomes a Victim when the original Victim turns Persecutor. Charvet and Berne both nailed the tendency (compulsion / pathology) that some of us have to want to help solve other people’s problems – whether they want us to or not. (Yep, I own up to playing this one more than a few times.) On the surface it looks altruistic but underneath is expresses a deep desire to be needed.

Pathological altruism may be a description of some facilitators’ behaviour I have witnessed, and I think there are other motives too.

Perhaps there is something called ‘pathological magician-ism’ or ‘pathological guru-ism’ or even ‘pathological Napoleon-ism’ — the desire to be seen to have the power to make people change. It is rife within some segments of NLP and hypnosis and is typified by a story about Richard Bandler.** To ‘help’ a person who had volunteered for a demonstration on a training change, Bandler apparently pulled out a gun and said “I don’t have to kill you, I just have to wound you”. (Note, I am not questioning whether the threat had the effect Bandler wanted, I’m suggesting it is an example where the action may have been motivated more by the therapist’s needs than the client’s.)

When asking therapists and coaches to discuss sessions that haven’t worked out well for the client I haven’t been met with a you’ve-got-goat-horns look, but I have seen plenty of blank stares and very few of them willing to discuss any of their own cases. Contrast this with the number of clients who have contacted me to describe their personal story of therapy that was more than unhelpful and unproductive, even if it didn’t go so far as to be destructive. From this I surmise that there are either a small number of therapists doing a lot of bad therapy or, more likely, a larger number that have the occasional session that goes badly awry (from the client’s perspective) which the therapist doesn’t notice, chooses to ignore, or deceives them self into thinking it never happened (Reframing is great for this).

Since I am certainly not immune from badly misjudging a therapeutic intervention I have reviewed those cases which meet the criteria. I have found two of my ex-clients who have been willing to describe in detail their experience of what happened between us. Using their accounts, and the accounts of clients of other therapists, I have started to put together a list of the conditions which give rise to client’s feeling therapy was invasive, an imposition or abusive. While prevention may be the best policy, therapy often requires both parties to take risks, and prevention is not always possible. In these cases early detection and a shift of direction is the next best option. I also asked these clients what they would have liked to have happen, once it was clear that they were not benefiting from the therapist’s approach. From this data I hope to be able to make some suggestions about how to ‘recover’ such a situation.

I shall describe my findings in later blogs.

* Natalie Angier, Selflessness Gone Awry, and the Damage It Can Cause, New York Times, 3 Oct 2011. www.nytimes.com/2011/10/04/science/04angier.html

** The Bandler Method by Frank Clancy and Heidi Yorkshire, Mother Jones Magazine, 1989. www.american-buddha.com/bandler.method.htm

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