Monday, October 26, 2015

Anna Stubblefield: Victim and Perpetrator

An article in  yesterday's New York Times told a remarkable story about Anna Stubblefield, former chair of the philosophy department at Rutgers University, who was convicted on two counts of aggravated sexual assault for having sex with a 31 year old man who the jury concluded was so severely disabled he could not consent to a sexual relationship.

The story hinges on "facilitated communication," a scientifically discredited practice that claims to achieve access to the hidden thoughts of persons with autism and other conditions that have hitherto precluded communication. In the technique, the "facilitator" claims to reach the "communication partner" by assisting the partner to type responses to questions.

I'd somehow never heard the fascinating history of facilitated communication until I read the NYT article. Imagine how moving it is to parents when they are told that their supposedly disabled offspring tells them that he is now overjoyed to be able to communicate and that he loves them very much. And imagine how horrified families are when the facilitated message accuses them of incest and other forms of violence.

I encourage readers who want to learn more about the scientific debunking of facilitated communication to follow the link above and to do a Google search for more. The phenomenon is reminiscent of the "Ouija Board," an occult practice that claimed to communicate with the dead. I remember my parents talking about Ouija Boards when I was a child. I believe they were joking about them, but many believed then that the board allowed spirits to speak to us, and it's still possible to purchase a board even now.

 But in this post I want to discuss the Anna Stubblefield case in connection to my many (21) posts on "doctor-patient sex." Here are my speculations, based solely on the New York Times article and the links it provided:
  1. I read excerpts from Professor Stubblefield's writings. They reflected intelligence, thoughtfulness, and passionate commitment to social justice.
  2. Reaching the hitherto unreachable is a noble aspiration, shared by physicians, educators and other  professionals.
  3. Facilitated communication involves intimate connection - including physical contact - between what I will here call "doctor" and "patient."
  4. As a result, it's a living Rorschach that allows the "facilitator" to project beliefs (as about the prevalence of abuse) and desires (as about sex) onto the "communication partner"/"patient".
  5. Professor Stubblefield and her supporters believe that her "communication partner"/"patient" was competent to consent to a mutually agreed upon sexual relationship.
  6. The family, the prosecutor, and the jury concluded that the "communication partner"/"patient" was not able to consent, and that the relationship was criminally exploitative.
  7. However, even on Professor Stubblefield's hypothesis that her "communication partner"/"patient" had the capacity for competent consent for a sexual relationship, in her role as "facilitator"/"educator"/"therapist," it was unethical for her to enter into the relationship.
  8. My guess is that Professor Stubblefield's treating the family as if they were harming their son & brother by opposing her relationship with him was especially provocative to them. They had been caring for their family member for 31 years and were now being told they were undermining his well being.
Professor Stubblefield will be sentenced next month, and could receive as much as 40 years in prison! Physicians who have sex with their patients may be sued for malpractice and may lose their licenses, but they are not subject to lengthy prison terms. My guess is that gender (female clinician/male patient) and race (white clinician/black patient) are major factors explaining why Professor Stubblefield could be punished so much more severely than male physicians who have sex with female patients. "Boys will be boys" is a deeply held societal perspective!

In 1992, Dr. Margaret Bean-Bayog, who I had the privilege of supervising when she did her residency in psychiatry, was the subject of sensationalistic press coverage and two books when she was accused of having had sex with a male patient who subsequently killed himself. She argued that the intense attention she received derived from public fascination with the concept of a rapacious female sexual predator. 

I believe Dr. Bean-Bayog was correct, and that similar forces are in the background of the public attention to Professor Stubblefield.  I agree with Professor Stubblefield's attorney that "...this has been a very unusual case. She fell in love. She has no prior history of sexual misconduct whatsoever. She has no criminal record." Professor Stubblefield acted unethically, but she should not be facing the possibility of a prolonged incarceration.


Anonymous said...

Doctors can lose their licenses when they consensual sex with their patients; they go to jail if they rape their patients. All the evidence suggests that Ms. Stubblefield's victim was mentally incompetent to give consent; he was raped. She should go to jail.

R. Streett, MD said...

Dear Dr. Sabin,

Your analysis of the complex facets of the Stubblefield case is excellent, but your conclusions are oddly confused given your appropriately skeptical appraisal of facilitated communication. Doctors, especially psychiatrists, risk disbarment and malpractice suits when they have CONSENSUAL sex with their patients. If they rape patients, they go to jail just like everyone else. Ms. Stubblefield clearly believed she had obtained consent, but all the evidence suggests that this belief was delusional. The victim in her case is grossly mentally incompetent, and the "consent" she obtained via facilitated communication no more credible than messages from a Ouija board. The jury appears to have understood all this and determined, correctly in my view, that the sexual acts constituted rape and not just professional boundary violations.

Yes, if the facilitated communications had been real Ms. Stubblefield would be deserving only of harsh professional censure and not incarceration. But they were so obviously not real.

R. Streett, MD

Jim Sabin said...

Dear Anonymous & Dr. Streett
Thank you for your thoughtful comments. You're right that physicians will and should be sanctioned for consensual sexual relationships with patients. But if Professor Stubblefield is seen as "delusional," that should be taken into account in sentencing, and in my view a prison term is not called for.
I looked at student responses to Professor Stubblefield on the "Rate my Professor" website. There were comments over a 10 year period, and she was clearly a competent, committed teacher. I'm more inclined to think of belief in facilitated communication as "mistaken belief" rather than as "delusion" in the sense of that word when it's used for psychotic illnesses. If I were asked about sentencing I would advise (1) probation, with a clear specification of no activities connected with "facilitated communication" or with individuals with any form of disability and (2) an apology to the family of her "communication partner"/"patient."

Anonymous said...

Dr. Sabin,

Your information about Facilitated Communication and this movement is limited. The damaging effects of this delusion is far reaching, it is not a personal delusion, it is a shared delusion. I am in contact with a main proponent of FC, who holds a law degree from Harvard, who believes his son communicates with FC - and when the facts about FC came out (being the ideomotor effect) many parents shifted into sharing insights they believe their children are in fact "telepathic." This proponent has shared with me that many of these parents, including himself, believe their children are telepathic. This is happening because some autistics have savant syndrome, which we know little about, but it makes autistics seem "magical". Now, this movement is spreading and quickly, and should be noted among those of us who are mental health clinicians. I have been studying this and commenting regarding the aspects of this case that Anna's former husband has reached out to me (which I find very strange but people are hurting and want the right support). Anna's parents firmly felt that FC is real, and Anna was publishing academic articles saying any opposition to FC was hate speech. This has reached the disability rights community and they are rallying by Anna, unbiased, because they feel that society is ableist and oppressive, so Anna's rhetoric really strikes them. We have public funding of FC! Even when many academic organizations are loudly warning against it, this is becoming a very complicated issue. One that involves autistic children and adults being paraded onto stages as "autistic masters" who carry important messages from spiritual epicenters. The dangers are clear, these children are used as operatives for any number of things, from sexual partners, to spiritual "prophets" - some of the court cases involved children being yanked from their homes as the facilitators sensed the children were being abused and then created the accusations in the dialog they were creating for the children!! When Anna was convicted, it was a huge blow to the FC community and sends a clear message that we are not going to let people be abused and used through the wiles of a competent facilitator's subconscious needs - and FC needs to be take out of the schools, and warned against! Anna going to prison is sending a clear message that needs to happen, and it needs to happen now! Dana Kuss RN

Anonymous said...

I want to add, the FC community is well aware that the APA has deemed it to not be valid. If Anna indeed had no former warning to the dangers of this, I would agree with you. Anna was known for her complete and utter defiance toward anyone who believed the studies that proved FC was driven by the facilitator. This knowledge is old, and people have been warned, over and over. There are a few articles circulating about the cult-like nature of FC - and in my research I will agree. If anyone posts anything regarding FC, parents will show up to scream at them, it's very emotional. FC has told parents their children are brilliant instead of impaired, this is not something people want to let go of. Anna is held to an even higher standard, being part of academia, she willingly ignores her peers. These cases with autistics are not going to end, because FC is very reminiscent of Scientology in refuting any psychological evidence and launching aggressive attacks on any opponent. They have parents show up at colleges if a professor or psychologist talks about FC, they will not take no for an answer. They are well funded, and are making a lot of money off of furthering this delusion. Before you brush off Anna as someone who is ignorant, I urge you to do more research. Your opinion does matter because we need to someone stop the practice of FC because it is hurting vulnerable people. This man had contusions and scrapes, did you know that? His body was contorted from years of CP and she forced it straight so she could straddle him. Painful and disgusting. Also, she still believes all of it, I doubt she would write an apology. My heart aches for these autistic children who are being tormented all day with their hands in the air, shouldn't they be touching sand, or tissue paper, and playing? Instead they are forced to go to college, and they have no idea what is happening, the facilitator is doing all of it! We are the ones that are supposed to be stopping this, and the clinicians need to step up and put a stop to it, not apologize for it!

Jim Sabin said...

Dear Donna Kuss/Ariel Burns (both names are on the comments)
Thank you for your very thoughtful and knowledgeable comments. Of course you're right that my information about FC is very limited. One of the pleasures of writing this blog is the opportunity to extend my purview on the world!
Given the pain and longing experienced by parents of offspring with autism it's not surprising that a debunked practice can be seized upon as a miraculous way to contact their children. And for "clinicians," FC can tap deeply cherished rescue fantasies that the "clinician" - via love, attentiveness, and sensitivity - can reach and save the hitherto unreachable. I'm sorry, but not surprised, to read your comments on how defensive and resistant to facts that are contrary to their wishes, advocates for FC are.
I've searched for information regarding sentencing in the Stubblefield case. I believe the sentence is still to come. From what you say, Professor Stubblefield may see herself as a martyr for truth, but I continue to regard an apology to the family and to the man who her false beliefs led her to abuse as an appropriate part of the sentencing outcome.