Art therapists in clinical settings may find themselves in the crossroads where legal issues, ethical considerations, and moral ramifications intersect. Sometimes they may even collide with one another, causing a real traffic snarl.
It is optimism—or naiveté—that has us believing that all legal, ethical, and moral guidelines work in harmony; that legality informs ethics, ethics inform legality and that they inform, and are informed by, morality. This is not always the case; a clinician may find himself caught between an institution’s regulations, his professional ethics, and personal morals.
At such times, strong instinctual decision-making skills are key. The therapist may be placed in a situation that interferes with the therapeutic process. Sometimes, the best the therapist can hope for is to mitigate the damage brought about by such conflict. However, mistakes may happen and poor decisions often get made.
I found such conflict occurred regularly in prison. Correctional environments are often considered anti-therapeutic, and institutional laws take precedence over professional ethics. As I teach my students, we must see ourselves as professional ambassadors, working within the parameters established in this sub-culture while introducing—but not force-feeding—new ideas and approaches.
Throughout most of my work in prison, I was fairly successful with this. However, there were times where conflict could not be avoided. And, like all professionals, I have made mistakes. I must confess my instinctual responses were not always correct.
A Humbling Example
Early in my work as an art therapist in prison—over 20 years ago—I asked the inmate members of an art therapy group I was leading to complete 3-D paper sculptures using paper, glue, water, and painting materials.
Little did I know, this would result in a confrontation with security that might have cost me my job and resulted in legal charges.
It did trigger ethical and moral failure.
Let me explain.
One group member was serving a life sentence. This 50-year-old man had already served over 20 years. He was the type of inmate who had accepted his fate. He was amicable and friendly. He simply wanted to do his time.
For his 3-D paper sculpture, he made a head. It wasn’t a large one—about half to two-thirds the size of a normal head. It was primitive looking but he took pride in it. While making it, he exhibited great focus, problem solving and confidence—a successful therapeutic outcome.
After the group, I collected all of the pieces and locked them up in a cabinet.
A recently promoted sergeant heard about it. An officer told me she wanted to see me. I went into the office where two other officers flanked her. She informed me that it was illegal for someone to “construct a head” as it could be used as a decoy for escape.
I had known her as an officer, and we had a good relationship; we always joked around.
I thought she was kidding. I laughed.
She did not. She told me sternly that if I did not destroy it, I could be “walked out” and brought up on legal charges for violating the institutional rules. She would not listen to my rationale, assurances or appeasements.
I became irritated and tried arguing about the futility of him using this as a fake head stuffed in his bed, a la Escape from Alcatraz. It was locked in the cabinet, there was no way for him to escape, and no one would be silly enough to confuse this with a real head. I even offered to ship it elsewhere or remove it from the premises.
There was no changing her mind. She was ready to have the two officers escort me off the grounds. She made me retrieve the head, and in front of her, destroy the piece the inmate worked so hard to complete. I broke it apart into little pieces, slammed it into the garbage, and went off in an impotent huff. I felt humiliated.
Now, I confess, I could have used this situation as a learning experience—as I say to my students, everything can be therapeutic grist for the proverbial mill. What I should have done, the morally correct thing, was to sit down with the client and explain the situation. Remind him that sometimes we find ourselves in circumstances out of our control; this is especially true in prison.
I did not do this.
Three days later, I met with this group again. The inmate asked me where the head was. Before I could say anything, another inmate in the group snidely remarked, “He probably had to throw it out.”
I must admit, this bothered me. I was annoyed that he probably understood the situation better than I had.
The artist’s response? “Nah; Dave wouldn’t do that. He prob’ly took it out. Didn’t you?”
Here was my opportunity. We could have had a meaningful discussion. Instead, I said…
That’s right—I chickened out.
I was still angry—I could have admitted this.
I was embarrassed for seeming naïve and ill considered—I could have said that.
I still felt impotent—I was no longer a professional with integrity, but instead let the system beat me down. Imagine the value if I admitted this?
And yes, I was still scared—I could have lost my job and have charges filed.
There were a hundred things I could have said. Instead, I let him believe I took it home. The group continued with no further questions.
I still carry this around.
Several years later, at a national art therapy conference, I presented a paper in which I confessed to this incident.
Since this occurred, In all the ethics courses I have taught, I have presented this as an example of what not to do, relying on the students to provide any action that would be better than what I did.
Yet, it has stayed with me over the years. I still feel ashamed when I reflect on it.
This scenario has always provided for me a clear example of the crossroads where legal, ethical, and moral situations may conflict, and how easy it is for us to lose our bearing.
To summarize, in this situation there were perceived and obvious violations of legal, ethical and moral standards.
Legal—According to the institution, I violated its laws. By allowing a therapeutically beneficial project to continue, I potentially abetted escape.
Ethics—In violation of our art therapy ethics documents, I failed to protect and respect the art piece that was a result of a therapy session.
Morals—Aside from being driven to destroy another person’s art piece, for which I already felt violated my personal morals, I lied to a client through omission.
Prison is already a difficult environment in which to provide therapy, and oftentimes clinicians are put in positions in which they must decide between maintaining the institution’s regulations and conduct meaningful therapy. They may, at times, find themselves compromising their own moral integrity. Such conflicts may actually be used to aide the learning, therapeutic, and adaptation process—for the inmates and the clinicians. However, errors may still occur.
To this day, it is my understanding that this inmate never found out what I did. To tell you the truth, he may not even be alive. Yet, I still feel horrible.
Art therapy pioneer Elinor Ulman once famously said that in therapy we must “…tell the truth, nothing but the truth, but not the whole truth.” I don’t think this is what she meant.