nice lady therapists

Appearing to enjoy behavior modificiation is not meaningful

One common response to criticism of ABA is to claim that people subjected to it enjoy it:

  • “My child loves his therapist and asks to go to sessions!”
  • “All of my clients smile and have fun!”
  • “My ABA is play based!”

What people forget is that affect is a set of behaviors, and that behavior modification methods work as well on affective behaviors as they do on anything else:

  • You can reinforce people to look happy
  • You can reinforce people to praise therapy
  • It doesn’t have to be an explicit part of the behavior plan to happen
  • And it can keep happening even after you fade direct prompts or direct intentional reinforcers

ABA programs give the therapist massive power over the person. That power in itself can cause people to look happy, through a more subtle reinforcement mechanism than takes place on a behavior plan:

  • If you have power over someone in the way that behavior therapists do, they’re going to be highly motivated to please you
  • If they figure out that you want to believe that they are happy, they are very likely to act like they are
  • If you treat them better when they display the affect you want or praise you, they’re likely to act happy.
  • It doesn’t mean they’re actually happy
  • Or that what you’re doing is good for them

(Also, affect often is an explicit part of someone’s behavior plan. It is not at all uncommon for ABA programs to involve actively ignoring distress and withholding attention and rewards until someone looks happy. It is not at all uncommon for ABA programs to involve teaching people to smile, to hug, or to otherwise do things that would out-of-context indicate happiness, enjoyment, or affection. It doesn’t have the same meaning if it’s prompted or trained.)

Also, programs based on positive reinforcement involving controlling someone’s access to stuff they care about:

  • The first step in a program based on positive reinforcement is to find out what someone most enjoys or cares about
  • (This is called a preference assessment or a reinforcement inventory. Here’s an example.)
  • And then making sure they have no access (or limited access) to those things outside of sessions or other situations in which someone is actively reinforcing them to do something
  • Of course if someone’s only access to everything important to them happens in sessions they will ask for sessions
  • That doesn’t mean they like the fact that someone has that level of power over them
  • (No one likes being manipulated that way.)
  • That doesn’t mean they like the things that the therapist makes them do
  • That doesn’t mean the power dynamic is harmless
  • That doesn’t mean ABA is a good approach to teaching

People who can’t say no, can’t say yes meaningfully. Looking happy isn’t meaningful if you’re rewarded for affecting happiness and punished for looking visibly distressed. Making the best of a bad situation isn’t consent.

alice-stewart-blues:

Nice Lady Therapists

dysfunctionalqueer:

realsocialskills:

Content warning: this post is about physical and emotional harm done to people (especially children) with disabilities by (mostly) female therapists. Proceed with caution.

This is a hard post to write. It’s about abuse. It’s about a kind…

alice-stewart-blues said:

Okay.  I see the same thing done by receptionists in doctors’ offices, this patronizing attitude when they are clearly trying to put you off but doing so with a phony smile and breeziness that belies the fact they are trying to get rid of you and as soon as possible.  Not to condemn them too much, though, because I know they are sometimes overwhelmed and having to deal with hundreds of people per week, but if we could all just be trained to deal with each person as humanely as possible, giving him or her our full attention when we are dealing with each of them and not bringing into the mix any preconceived and perhaps bigoted perceptions, then all would be well in a perfect world.  Alas, all we can do is to bring this sort of thing to everyone’s attention.

realsocialskills said:

What I’m talking about goes beyond that kind of level of condescension.

Therapy is intimate in a way that dealing with a mean receptionist isn’t.

Condescending receptionists want you to feel bad about yourself and leave them alone.

Nice Lady Therapists want you to feel bad about yourself in a way that draws you closer to them. They want you to feel grateful and praise them. They want you to think they’re amazing and wonderful and saving you, and that even the painful and humiliating things they do to you are ultimately wonderful.

Nice Lady Therapists

Content warning: this post is about physical and emotional harm done to people (especially children) with disabilities by (mostly) female therapists. Proceed with caution.

 This is a hard post to write. It’s about abuse. It’s about a kind of abuse I haven’t seen described much. I think abuse is the right word, even though a lot of abusers probably genuinely think they’re doing the right thing.

Anyway, here goes:

Many, many people with disabilities I know have been harmed or even outright abused by Nice Lady Therapists. (Usual caveat: not all therapists are abusive, and this post is not opposition to childhood therapy. I’m saying that therapists need to stop hurting kids and other vulnerable people, not that therapy is evil. Pointing out that therapy is often important and that many therapists are good is not an answer to what I am describing.)

 

Nice Lady Therapists tell us that, whatever they do to us is by definition nice, and good for us. And that we like it, and that they love us, and that they are rescuing us, and that we are grateful.

They have a brightly-decorated therapy room full of toys, and assure every adult they come across that ~their kids~ love therapy. They use a lot of praise and enthusiastic affect, and maybe positive reinforcement with stickers and prizes. They might call the things they have kids do games. Some of them really do play games.

And every interaction with them is degrading in a way that’s hard to pinpoint, and hard to recover from. They do all kinds of things to kids with disabilities that typically developing kids would never be expected to tolerate. And they do it with a smile, and expect the kids they’re doing it to to smile back.

Sometimes it hurts physically, sometimes it hurts emotionally. Sometimes it’s a matter of being 12 years old and expected to trace a picture for toddlers for the zillionth time. And being told “This is fun! I used to do this all the time when I was a kid!”.

Sometimes it’s a matter of being forced to do a frightening or physically painful exercise, and being forbidden to express pain or fear. It hurts their feelings if a kid is upset. Don’t we know how much she cares? Don’t we know that she’d never do anything to hurt us? Don’t we want to learn and grow up to be independent?

Sometimes it’s a matter of being expected to accept intensely bad advice as though it’s insight. For instance, getting sent to therapy because you’re not making friends. And being told “We are all friends in this school! You have to give the other kids a chance.” And, if you try to explain otherwise, she patiently and lovingly explains to you why your thinking is distorted and you’ll have lots of friends if you just let yourself try.

Sometimes it’s - crossing a physical line. Touching in a way they have no good reason to be touching. Or touching over the objections of the kid in a way that is in no way justified by therapy goals. Sometimes sexually, sometimes not. Sometimes in ways that are against ethical standards of practice, sometimes not. But intimately, invasively. And if you say no, she patiently, lovingly, explains that you have nothing to be afraid of and that everything is ok. And that if you just trust her, you will have fun and get better. And when her profession has professional training about boundaries and appropriate touch, she thinks or even says “women don’t do that.”

Some male therapists do many of these things too, but there’s a gendered version of it that usually comes from women. And that can cause a problem for people with disabilities who are recovering from this. Most things about trauma and abuse of power are about misogyny in some way. They’re about men hurting women, and taking advantage of power dynamics that favor men to do so. Those descriptions are important because that pattern is common. But it is not the only abuse pattern, and it is not the only gendered abuse pattern.

Female therapists are subjected to misogyny and the power of men just as much as any other women. But they also have tremendous power over people with disabilities, many of whom are deeply dehumanized. The assumption that women have neither the power nor the ability to hurt anyone gets really dangerous really quickly for children with disabilities receiving therapy.

And it also means that people with disabilities often have a different relationship to gender than most nondisabled people. If you’ve been harmed by women over and over and assured that you liked it, it complicates things. If you’re a girl, it can make it hard to see a group of women as a Safe Space, especially if they think the thing making it safe is keeping the men out. If you’re a boy who has been repeatedly harmed by women who believed they were powerless, it can be hard to understand that the gender hierarchies that feminists and others talk about actually do exist. And it complicates things in any number of other ways.

But if you have been hurt by Nice Lady Therapists, you are not alone. If it has affected your relationship to gender, you are not alone. If it has left scars that others say you shouldn’t have because she was nice and meant well, you are not alone.

You don’t have to think someone is nice because she says she is. It’s ok to think that someone is hurting you even if that upsets them. You don’t have to think someone is safe or loving just because they are a woman or a therapist or smiling. Women can be abusive too. In human services, it is common. You are not alone, and it was wrong to treat you that way. The harm done to you was not because of your disability, and it’s not something that you could have fixed by being more cooperative or working harder or having a better attitude.  It’s not your fault, and it’s not because of anything wrong with you. And it’s not your fault if it still hurts. 

I’m not sure what else to say about this today. I think that there is a lot that needs saying (and I hope I will find some of it in the comments.) Any of y'all want to weigh in?

walkingsaladshooterfromheaven:

Nice Lady Therapists

realsocialskills:

Content warning: this post is about physical and emotional harm done to people (especially children) with disabilities by (mostly) female therapists. Proceed with caution.

This is a hard post to write. It’s about abuse. It’s about a kind of abuse I haven’t seen described much. I think…

walkingsaladshooterfromheaven said:

Not therapists specifically but other women in “helping” roles, particularly teachers/education professionals, have been this way to me.

In varying ways and to varying degrees. But there is a dynamic there.

It’s a “What I’m doing to you is for your own good and I’m being sweet and nice about it so you have no right to complain” sort of thing.

It’s subtle disrespect and dehumanization, in which they completely deny that that’s what they’re doing to you. It’s very gaslighty. And it is an attitude that is frequently encouraged among female education professionals.

It’s so terrifyingly ubiquitous and there are so very few guaranteed safe spaces from it.

Even women who do not normally have this attitude can take it on if they feel like you are being enough of a Problem to warrant it.

realsocialskills said:

Yes. As though being nice is a tone of voice, and that it does not require actual respect.

Nice Lady Therapists

dysfunctionalqueer:

realsocialskills:

Content warning: this post is about physical and emotional harm done to people (especially children) with disabilities by (mostly) female therapists. Proceed with caution.

  

This is a hard post to write. It’s about abuse. It’s about a kind of abuse I haven’t seen described much. I think abuse is the right word, even though a lot of abusers probably genuinely think they’re doing the right thing.

 

Anyway, here goes:

 

Many, many people with disabilities I know have been harmed or even outright abused by Nice Lady Therapists. (Usual caveat: not all therapists are abusive, and this post is not opposition to childhood therapy. I’m saying that therapists need to stop hurting kids and other vulnerable people, not that therapy is evil. Pointing out that therapy is often important and that many therapists are good is not an answer to what I am describing.)

 

Nice Lady Therapists tell us that, whatever they do to us is by definition nice, and good for us. And that we like it, and that they love us, and that they are rescuing us, and that we are grateful.

They have a brightly-decorated therapy room full of toys, and assure every adult they come across that ~their kids~ love therapy. They use a lot of praise and enthusiastic affect, and maybe positive reinforcement with stickers and prizes. They might call the things they have kids do games. Some of them really do play games.

And every interaction with them is degrading in a way that’s hard to pinpoint, and hard to recover from. They do all kinds of things to kids with disabilities that typically developing kids would never be expected to tolerate. And they do it with a smile, and expect the kids they’re doing it to to smile back.

Sometimes it hurts physically, sometimes it hurts emotionally. Sometimes it’s a matter of being 12 years old and expected to trace a picture for toddlers for the zillionth time. And being told “This is fun! I used to do this all the time when I was a kid!”.

Sometimes it’s a matter of being forced to do a frightening or physically painful exercise, and being forbidden to express pain or fear. It hurts their feelings if a kid is upset. Don’t we know how much she cares? Don’t we know that she’d never do anything to hurt us? Don’t we want to learn and grow up to be independent?

Sometimes it’s a matter of being expected to accept intensely bad advice as though it’s insight. For instance, getting sent to therapy because you’re not making friends. And being told “We are all friends in this school! You have to give the other kids a chance.” And, if you try to explain otherwise, she patiently and lovingly explains to you why your thinking is distorted and you’ll have lots of friends if you just let yourself try.

Sometimes it’s - crossing a physical line. Touching in a way they have no good reason to be touching. Or touching over the objections of the kid in a way that is in no way justified by therapy goals. Sometimes sexually, sometimes not. Sometimes in ways that are against ethical standards of practice, sometimes not. But intimately, invasively. And if you say no, she patiently, lovingly, explains that you have nothing to be afraid of and that everything is ok. And that if you just trust her, you will have fun and get better. And when her profession has professional training about boundaries and appropriate touch, she thinks or even says “women don’t do that.”

Some male therapists do many of these things too, but there’s a gendered version of it that usually comes from women. And that can cause a problem for people with disabilities who are recovering from this. Most things about trauma and abuse of power are about misogyny in some way. They’re about men hurting women, and taking advantage of power dynamics that favor men to do so. Those descriptions are important because that pattern is common. But it is not the only abuse pattern, and it is not the only gendered abuse pattern.

Female therapists are subjected to misogyny and the power of men just as much as any other women. But they also have tremendous power over people with disabilities, many of whom are deeply dehumanized. The assumption that women have neither the power nor the ability to hurt anyone gets really dangerous really quickly for children with disabilities receiving therapy.

And it also means that people with disabilities often have a different relationship to gender than most nondisabled people. If you’ve been harmed by women over and over and assured that you liked it, it complicates things. If you’re a girl, it can make it hard to see a group of women as a Safe Space, especially if they think the thing making it safe is keeping the men out. If you’re a boy who has been repeatedly harmed by women who believed they were powerless, it can be hard to understand that the gender hierarchies that feminists and others talk about actually do exist. And it complicates things in any number of other ways.

But if you have been hurt by Nice Lady Therapists, you are not alone. If it has affected your relationship to gender, you are not alone. If it has left scars that others say you shouldn’t have because she was nice and meant well, you are not alone.

You don’t have to think someone is nice because she says she is. It’s ok to think that someone is hurting you even if that upsets them. You don’t have to think someone is safe or loving just because they are a woman or a therapist or smiling. Women can be abusive too. In human services, it is common. You are not alone, and it was wrong to treat you that way. The harm done to you was not because of your disability, and it’s not something that you could have fixed by being more cooperative or working harder or having a better attitude.  It’s not your fault, and it’s not because of anything wrong with you. And it’s not your fault if it still hurts. 

I’m not sure what else to say about this today. I think that there is a lot that needs saying (and I hope I will find some of it in the comments.) Any of y’all want to weigh in?

dysfunctionalqueer said:

I can’t weigh in atm but i might be able to in the future, but yeah. This is a thing that happens, and the abuse caused to me by a Nice Lady Therapist ™ caused and still causes me to avoid and lie and fear treatment and has caused my illnesses and disabilities to get worse because of that. 

realsocialskills said:

Yes. It’s really hard to get treatment of any kind when Nice Lady Therapists make medical treatment and therapy language triggering, even if you grow up and have access to non-abusive treatment.

Nice lady therapists told me that restraint doesnt hurt, theyre keeping me safe. They put me in a baskethold and said it was a hug. They followed me to the bathroom when i was a teenager and made me do coloring sheets. They made me hug and cuddle and pretend to like it. They made me earn everything and acted like they were giving me a gift. If i didnt want their help it was problems accepting that others cared about me.
realsocialskills said:
 
I’m sorry that Nice Lady Therapists abused you in all of those ways. They shouldn’t have.

Nonviolent Communication can hurt people

People who struggle interpersonally, who seem unhappy, or who get into a lot of conflicts are often advised to adopt the approach of Nonviolent Communication. 

This is often not a good idea. Nonviolent Communication is an approach based on refraining from seeming to judge others, and instead expressing everything in terms of your own feelings. For instance, instead of “Don’t be such an inconsiderate jerk about leaving your clothes around”, you’d say “When you leave your clothing around, I feel disrespected.”. That approach is useful in situations in which people basically want to treat each other well but have trouble doing so because they don’t understand one another’s needs and feelings. In every other type of situation, the ideology and methodology of Nonviolent Communication can make things much worse.

Nonviolent Communication can be particularly harmful to marginalized people or abuse survivors. It can also teach powerful people to abuse their power more than they had previously, and to feel good about doing so. Non-Violent Communication has strategies that can be helpful in some situations, but it also teaches a lot of anti-skills that can undermine the ability to survive and fight injustice and abuse.

For marginalized or abused people, being judgmental is a necessary survival skill. Sometimes it’s not enough to say “when you call me slurs, I feel humiliated” - particularly if the other person doesn’t care about hurting you or actually wants to hurt you. Sometimes you have to say “The word you called me is a slur. It’s not ok to call me slurs. Stop.” Or “If you call me that again, I’m leaving.” Sometimes you have to say to yourself “I’m ok, they’re mean.” All of those things are judgments, and it’s important to be judgmental in those ways.

You can’t protect yourself from people who mean you harm without judging them. Nonviolent Communication works when people are hurting each other by accident; it only works when everyone means well. It doesn’t have responses that work when people are hurting others on purpose or without caring about damage they do. Which, if you’re marginalized or abused, happens several times a day. NVC does not have a framework for acknowledging this or responding to it.

In order to protect yourself from people who mean you harm, you have to see yourself as having the right to judge that someone is hurting you. You also have to be able to unilaterally set boundaries, even when your boundaries are upsetting to other people. Nonviolent Communication culture can teach you that whenever others are upset with you, you’re doing something wrong and should change what you do in order to meet the needs of others better. That’s a major anti-skill. People need to be able to decide things for themselves even when others are upset.

Further, NVC places a dangerous degree of emphasis on using a very specific kind of language and tone. NVC culture often judges people less on the content of what they’re saying than how they are saying it. Abusers and cluelessly powerful people are usually much better at using NVC language than people who are actively being hurt. When you’re just messing with someone’s head or protecting your own right to mess with their head, it’s easy to phrase things correctly. When someone is abusing you and you’re trying to explain what’s wrong, and you’re actively terrified, it’s much, much harder to phrase things in I-statements that take an acceptable tone.

Further, there is *always* a way to take issue with the way someone phrased something. It’s really easy to make something that’s really about shutting someone up look like a concern about the way they’re using language, or advice on how to communicate better. Every group I’ve seen that valued this type of language highly ended up nitpicking the language of the least popular person in the group as a way of shutting them up. 

tl;dr Be careful with Nonviolent Communication. It has some merits, but it is not the complete solution to conflict or communication that it presents itself as. If you have certain common problems, NVC is dangerous.