Thursday, October 29, 2009

What I Learned Part 1

Here's a brief summary of tidbits from the first day of the American
Academy of Psychiatry and Law conference.

First, there was an interesting keynote by Dr. Pat Recupero regarding
how to incorporate questions about the use of the Internet into the
mental status examination and the ethics of googling patients. (Shrink
Rap reader?)

The Indiana v Edwards case is a popular topic for presentation.
Defendants who represent themselves at trial are more likely to be
convicted of misdemeanors than felonies. Lots of discussion about how
pro se competence should be assessed and what the standard should be.

Got to meet and listen to Dr. Steve Morse, doing some of the most
fascinating research in forensic neuroscience. He stated functional
MRI will likely never be determinative of any legal issue. Favorite
quote: "Brains don't kill people, people kill people." Followed by:
"The only thing we know for sure about the mind and the brain is that
when the brain is dead, the mind is gone."

Six Federal jurisdictions have case law to bar third party observers
(ie lawyers) from forensic evaluations.

There are still people writing books about ritual cult abuse. They are
still not acknowledging that some claims may not be true, not even
after multimillion dollar malpractice actions for implantation of
false memories and exoneration of alleged perpetrators.

There was a presentation about expert witnesses' transference
reactions to attorneys and defendants. I think this is a pretty broad
stretch of the term.

Interesting historical overview of multiple personality disorder. The
patient Sybil had her sessions recorded. Her psychiatrist, Dr. Wilbur,
can be heard invoking and assigning names to her alters. The patient
Eve, Chris Sizemore, later wrote an autobiography repudiating her
diagnosis. Fifty-seven percent of audience (forensic psychiatrists)
did not believe in the disorder. Fifteen percent of surveyed general
psychiatrists think dissociative identity disorder should be removed
from the DSM. There was discussion of the role of the media and the
book Courage to Heal in precipitating the DID epidemic. DID experts
themselves disagree about the literal reality of satanic ritual abuse.
Some say this is a metaphor for severe psychological trauma. The FBI
division for offenses against children has never found evidence of
such cults.

Burgus v Braun is a landmark case for anyone working with trauma
patients. It resulted in a 10.3 million dollar settlement against
therapists for malpractice and Dr. Braun was expelled from the APA.