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I was a psychotherapist before I went to law school. The scariest things were surprising. Early in my career as a therapist, the scariest thing someone talked to me about was that she had a crush on me. I hadn’t thought through this possibility yet in my sessions with my mentor, so it was both a surprise and an intimidating one to respond to. I had to cover the issue of “no, this won’t happen” with her, at the same time figuring out what the diagnostic significance of this disclosure was and ultimately, how we could use this as a way to practice more appropriate behavior and maybe also discuss resolving some issues in a therapeutic way, without putting my own career in danger of being accused of either leading her on or turning her down in an insensitive and untherapeutic way?Further in, there were the clients who would threaten suicide or homicide during the session. By the time I got to that part of my career, I was prepared. There is a risk assessment evaluation that a therapist needs to go through when encountering this kind of issue, and the response you make to the threat depends upon what the different issues in the risk assessment present. For example, someone who feels hopeless about life and wants to just disappear, but has no plans for how to accomplish this, is VERY different from the one who is sitting in their living room with a cocked gun on his lap and called in to the suicide hotline to try to figure out if there’s a way to stop himself from pulling the trigger (in situation # 2, I notified the team of people I was working with and they had law enforcement with a crisis negotiator out to his house as I kept him on the phone. Once they were in place, I explained that his threats were very serious and that I was taking them seriously, asked if he knew what a therapist should do whose client was threatening suicide and he mentioned he felt it should be disclosed to others. I explained that he was right and that I had a whole team of people ready to help him and all we had to do was to get him to put down the gun and unlock the door. Seriously it was not as quick & easy as this, there was a lot more to it, but it worked and he was taken in to get help.)I had some clients who were potentially physically dangerous towards anyone, including therapists, so I learned “assaultive behavior management” (which is a version of self defense where you protect yourself and contain the violence but don’t necessarily go on the offensive against the assaultive person), and in one instance where a chair was thrown at my head, I DUCKED. You learn not to let the scary person get between yourself & the door, and you learn to make sure doors are locked behind you as you walk out of a locked facility after doing your rounds and having therapeutic visits with some of the facility residents. You learn to FACE the entryway of any given room so that the assaultive people can’t sneak up behind you while you’re in session with anyone else. It’s just a way of conducting yourself that’s less about how cool it is to be working with such interesting issues and more about how much you, the professional, can control the therapeutic environment so that everyone can stay safe and keep moving forward in a therapeutic fashion.The worst things that I ever heard were the things that would make just about anyone cry, just sad, pathetic, “who would DO that to someone” kinds of things that made you wonder if your client, the victim of this stuff, would ever be able to recover and feel safe in the world. Knowing how to keep the therapy room safe for them to talk in, is about being a professional rather than getting all maternal-instinct-ish with them. (if the maternal role were a safe one in their lives, they might not be in my office, right? so we gotta keep from letting our own feelings of counter-transference develop when they’re busy disclosing all these scary things about their own past… most good therapists will have a peer or a group of peers to discuss these issues with, to prevent inappropriate and un-therapeutic situations from developing).I had some other clients, teens & children, who disclosed that they were BEING abused (not just stories of a sad past), by family members or friends of family (every one of the stories is different). There is also a mandatory protocol for therapists to follow when that kind of situation arises. If you’ve been trained properly as a therapist, by the time you come to the point where the clients are disclosing really scary things, you have a series of responses at the tip of your tongue, ready to put into action. At the point of a scary disclosure, it’s not about listening to them complaining that their mom won’t buy them a car or their dad didn’t approve of their sexuality, but more about putting into practice a series of steps that are required and that are proven to help diffuse the dangerousness of any given scary situation.And be aware, for someone who wants to become a therapist, these situations are pretty common. It’s not an everyday thing, but it’s frequent enough that you’ve GOT to be on your toes and have the protocols at your fingertips so you can have an action plan when the dangerous situation arises. IF you’re properly trained, it’s NOT about deciding whether you’re attracted to the client, or whether you can defuse the situation without any assistance from peers or law enforcement. It’s about figuring out whether the person presents an immediate physical danger to themselves or someone else, and how to address that danger.For those who have a prurient interest in finding out scary personal stories of psychotherapists’ clients, there are a zillion books out there that should satisfy your rubberneck fantasies. The reality of a scary person revealing scary stuff in a therapist's’ office is a whole lot less about the gory details and a whole lot more about making sure the disclosure results in the least possible danger to the client or therapist or public at large.

When people communicate face to face, we’re evaluated by a lot of different aspects, not only of what we say, but also about how we say it. Factors that influence how you’re perceived includes:The actual words that you say.The tone of your voice.The volume of your voice.The pacing, the breaks, the speed of your speech.Your facial expression.Your posture.The amount of, and type of eye-contact you make.Your clothing, your makeup, your shaving, your hair.Your age, perceived social class and perceived assertiveness, extroversion and social dominance.In text, most of this except for the first is stripped away.Autistic people often have differences to neurotypical people in most of the rest of these factors, and we’re typically judged very harshly for it.There’s been actual science done on this. For example in one experiment I think is illustrative, a group of autistic and neurotypical students are filmed while they quickly present and introduce themselves, a 30 second movie. [1]Then the content of these videos are shown to a group of neurotypical people who are asked to judge the people in a variety of ways.Are they attractive?Are they awkward?Are they likeable?Are they smart?Are they dominant?Would you like to sit next to this person?Would you like to hang out with this person?Would you like to talk to this person?You get these results:Autistic people are systematically judged as more awkward, less attractive, less dominant and less likeable. (but fairly equally trustworthy and smart) People express notably less interest in hanging out with us, talking to us and sitting next to us, but it makes no big difference to living near us.The interesting thing is what happens when you present the content from the video in different ways:One group gets to hear only the audio, without seeing the person talking.One group gets to only see the person, without hearing the words.One group gets only a written transcript of the actual words.One group gets only a neutral still photo from the video, i.e. only a picture of the person.Here’s the results:You’re precisely right. In “speech content”, i.e. in text, people on the spectrum are on the average judged almost as positively as neurotypical people. (1.57 as opposed to 1.65)But notice what happens when you include audio or pictures.The scores for neurotypical people shoot up to 1.73 - 1.87.But the scores for autistic people go down to 1.35 - 1.5 and is lowest of all for “audio-visual” i.e. the situation closest to face to face meeting.We’re the same people either way of course, it’s just that in text we can avoid the harsh negative judgements we often receive from neurotypical people over factors beyond the actual content of our words.To be blunt, neurotypical people tend to make a better impression on each other if they can see and hear each other, not only read the actual words. Meanwhile, autistic people tend to get judged more negatively if you can see and/or hear us compared to if you can only read our actual words.You asked WHY though.My thinking is that this happens because neurotypical people implicitly assume everyone is more or less like them. So they will for example judge my behavior as if I was feeling what they’d be feeling if they behaved that way.As an example, if they were not making eye-contact while in a conversation, it’d probably mean they’re bored, uncomfortable or looking for a way out of the conversation. So if I don’t do that, they assume (incorrectly!) that it means the same thing for me.Footnotes[1] Neurotypical Peers are Less Willing to Interact with Those with Autism based on Thin Slice Judgments

Oh wow, yes! There was a doozy.In early 1988, a French immunologist of repute, Jaques Benveniste, submitted a paper to the top science journal, Nature, called The Memory of Water. Therein they claimed that following successive dilutions to the point that there would be a negligible probability for any active molecules to be present in the solution, the solution still exhibited a biological response. The paper was well written and seemed quite thorough and methodical and the research group had an established reputation in biomedical research. The paper went through peer review and was published!However, there appeared to be no reasonable physical explanation for why water would retain a memory, especially at room temperature with an abundance of thermal energy. The Nature editors must have gone through hell, letting this paper get past, but they did actually publish it, suggesting that it had satisfied peer review. However, John Maddox, the chief editor of Nature made the unprecedented move to publish an editorial in the same volume urging readers to be skeptical of the result. He wrote in his editorial comment, "There are good and particular reasons why prudent people should, for the time being, suspend judgement"Moreover, the editors were so concerned with the work that they adopted yet another unprecedented approach. This time they appointed a team of independent skeptics to travel to the Benveniste lab where they would oversee the replication of the reported results according to strict protocols. The team included renowned skeptic James Randi.The properly double blinded experiments failed to replicate the earlier results, prompting the oversight team to publish the following assessment in the very next volume: Maddox's team concluded "that there is no substantial basis for the claim that anti-IgE at high dilution (by factors as great as [math]10^{120}[/math]) retains its biological effectiveness, and that the hypothesis that water can be imprinted with the memory of past solutes is as unnecessary as it is fanciful." .The original Benveniste paper was subsequently retracted and is now no longer available.However, undeterred, Benveniste carried on with his research and eventually claimed that the memory effect could be transmitted over the phone or even through the internet. Benveniste published other papers from this work, but by this stage his work was considered marginal and discredited. He even lost his position at his institute and had to go it alone, running on the sponsorship of those who believed in his work.The July 1989 edition of Nature reported that INSERM placed Benveniste on probation following a routine evaluation of his lab. Although INSERM found that his laboratory activities overall were exemplary, it expressed severe discomfort with his high dilution studies, and criticized him for "an insufficiently critical analysis of the results he reported, the cavalier character of the interpretations he made of them, and the abusive use of his scientific authority vis-à-vis his informing of the public"The work of Benveniste did attract a few followers, some of whom reported evidence that corroborated Benveniste’s claim. However, none of the claims has satisfied the requirement of repeatability, and hence have been disregarded.The whole affair is a great example of science being openminded yet pedantic. Substantial claims require substantial proof. There can be no exception. I applaud Nature for the way they handled this affair.Jaques Benveniste died in Paris in 2004.Water memory - WikipediaJacques Benveniste - Wikipedia