Hi everyone, Brandon here. Come on in, have a seat. I know what you’re thinking… “Hey Jedi Counsel, this is not one of the classic psychological evaluations about one of my favorite, beloved fictional characters that I’ve come to expect every month or so! What gives?” Well, let me tell you what gives, friend. This is my fifth year of graduate school and last semester at North Dakota State University. This summer I will begin the final year of my Ph.D., which will consist of a full time, yearlong clinical position at a non-profit community mental health clinic. I’m entering a time of pretty significant personal change. I started at NDSU during my undergraduate. The university and my status as a student have been a central part of my identity for a very long time. I’ve been reflecting a lot about the transition out of this role and into my new role as a full-time clinician. Because this, I started thinking a lot about my favorite fictional character and the lessons I can take from him to help guide me in my clinical work. To that end, I asked my ever-accommodating co-host/blogger if we could mix it up this month. Please get comfortable as I take you through a journey of the lessons I’ve learned from Batman that I believe could apply to being a good therapist.
Lesson 1: Do what is right, even if it is not always easy.
“It has nothing to do with easy. It’s about doing what’s right because it’s right. That’s the only reason you need.” – Batman
When Bruce Wayne was very young, he witnessed the murder of his parents. This was a life-altering event for Bruce that would dramatically change the trajectory of his life. In response to this, he made it his mission to do whatever he could to prevent other people from having the same experience that he had. Now, depending on the nature of the event, available social support, and the overall psychological make-up of an individual, people can respond to trauma in many ways. This is just the way Bruce Wayne responded (though it isn’t clear that he ever emotionally recovered from the loss of his parents, see here for more info). It’s clear this wasn’t easy for him, though. He could have had a perfectly relaxing life, relying on his fortunes to live comfortably and happily for all his days. He has a mansion and cars and even a butler. He had it made in the shade. Instead he chose to do what he felt was right and become Batman. Years of study and training (sound familiar?), self-sacrifice, and a rough road were the rewards Batman got. Nevertheless, he continued to move forward to help make the world a little bit better for the people in his city.
To me, this applies directly to clinical work. We simply have to do what is right. Specifically, we are expected to act in accordance to the ethical standards prescribed to us (click here to see the wiki that I helped to write that outlines the APA Ethics Code!). At times, these situations aren’t always easy. Mandated reporting is an example. You might have a strong therapeutic relationship with a client. You could feel like you’re really making progress. But if you learn about an incident or behavior that you’re required to report, it has to happen (note: the client would be informed of this during the informed consent for treatment). Other examples include avoiding, or if necessary, navigating dual-relationships, maintaining confidentiality, respecting client autonomy, identifying and practicing within your competency areas, maintaining thorough documentation, and sticking to evidenced-based treatments and assessments. These are just a few of the many examples where clinicians might face challenging situations. It’s important that we rely on our ethical codes to do what is right in the same way that Batman relies on his own personal moral code to do what is right in his war on crime.
Lesson 2: Stand up for those who might not be able to stand up for themselves.
“I’ll be standing where I belong. Between you and the people of Gotham.” – Bruce Wayne, Batman Begins (2005)
The center of Batman’s mission is doing all he can to prevent anyone from experiencing what he experienced as a child. This theme is consistent throughout the many stories of Batman across the various mediums. For example, in the recent Batman comic series authored by Tom King, Batman takes control of an airplane that is going to crash into Gotham City. He intends to divert the plan and crash with it. Another example is in Nolan’s The Dark Knight (2009), in the end Batman takes the blame for everything Harvey Dent did so that the people still have someone to look up to. In the 2015 video game, Arkham Knight, Batman sacrifices himself to save the city from Scarecrow’s chemical attack. It seems like almost every Batman story has an element of him taking to hit, pain, or blame so that someone else can be spared.
To me this translates to engaging in advocacy work. As a field, Clinical Psychology has not always done a good job advocating for those who may need it. Looking back at the history of how the LGBTQ+ communities were treated within our field is a good example of this (see our Jedi Counsel episode for a primer on this and a list of further resources). I believe that people should advocate for whatever social justice rights that lead to the betterment of others that they are comfortable with. Due to our clinical training, our expertise is in mental health. So one potential area of professional advocacy falls clearly in that realm. One example is challenging the claims that failures in our mental health systems are the cause of violence (see here for a brief fact-sheet outlining the research between mental health and violence). Another example might be disseminating mental health resources so individuals know where to get help (we just gave a talk related to this recently on campus!) Or it might be just doing what you can in your day to day life to reduce mental health stigma which can sometimes take the voice from others and keep them from getting help they might need. Batman makes it a point to stick up for people who might be going through tough times and may not have a voice or way of defending themselves. Through our expertise and clinical work, we have the opportunity to do the same.
Lesson 3: You don’t have to be a superhero to make a difference.
“A hero can be anyone. Even a man doing something as simple and reassuring as putting a coat around a young boy’s shoulders to let him know that the world hadn’t ended.” – Bruce Wayne, The Dark Knight Rises (2012)
In The Dark Knight Rises, Batman tells Jim Gordon how he was a hero to him when he was younger and coping with the loss of his parents. We see this role reversed many times throughout several Batman stories. When many people think of Batman, they think of the rough and tough dude in a suit who punches the baddies and saves the day. However, for folks who have had the good fortune to dig deeper into the character through the various comic book series or animated depictions, we see a much softer side of Batman from time to time. A perfect example of this can see seen in the Justice League cartoon. Amanda Waller wants to destroy a young girl who has developed terrible powers. Instead of doing so, Batman goes and sits with the young girl on a swing set and holds her hand while she dies as a result of her powers. In Batman, we have a character who has no super-powers at all but still manages to go toe-to-toe with aliens, Amazons, and gods. Despite that, he never forgets what it means to be a hero for him.
For clinical work, it’s important for each of us to remember the impact that we can have. It is a fairly safe assumption to assume that most people go into mental health because they want to help others. However, between a lot of schooling, navigating licensure, tough hours, large caseloads, challenging clients, difficulties in insurance reimbursement, and the many, many other things involved in clinical work, it can sometimes be easy to lose sight of what your initial goal was. It can be helpful from time to time to reframe things and remind oneself what an honor it is that you have the opportunity to step into these peoples’ lives and help them get to a better place. Just by meeting with you, clients can learn new skills, get regular social interaction, learn more about what they are experiencing through psychoeducation, and receive validation through normalization that others are likely struggling with the same disorder or challenges that they are. Any one of those benefits alone can really mean something to someone who is struggling. For young Bruce Wayne, having Jim Gordon hang a coat on his shoulders was everything in the world for him. For your clients, you can serve the same role by simply being collaborative in providing an explanation for what they are experiencing, which alone can help them feel better and more hopeful (see here for a study on how careful diagnostic feedback leads to increases in positive emotions and hope).
Lesson 4: Be humble and know when to ask for help.
“The first truth of Batman… It had to be one I didn’t like to admit. The gunshots left me alone. For years I was alone in the echoing dark of that well. But something else defined the exact moment Batman was born. The First Truth of Batman… The saving grace. I was never alone. I had help.” – Bruce Wayne, The Return of Bruce Wayne
Another major theme of Batman is that despite his independent nature and desire to work alone, he always knows when he needs to ask for help. Whether it is having a side-kick, relying on Alfred, or calling in the Justice League, Batman knows when he needs back-up. Part of this is that he acknowledges his skills. For example; he can’t fly. In the Justice League animated series, there is a scene where he calls in for some air support (see here). Or in the newest Justice League (2017) film, Batman recognizes that something beyond him is coming to Earth. As such, he recruits Wonder Woman and others to join him in preventing an invasion.
For Batman, it all boils down to knowing his skills and knowing when he needs help. In clinical work, it is largely the same. We know that therapist competence is largely predictive of therapy outcomes (see here for a study related specifically to Cognitive Behavior Therapy for depression). As such, it is important to recognize when a client has a problem or requires a treatment that falls outside of your competence area. Additionally, it is important to seek support when you need it. This can be in the form of supervision when you are still developing or perhaps learning a new treatment. Another way of seeking support is through consultation. Consulting with a peer or other professional can help to illuminate problems or ideas you might have missed. Consultation can also help with treatment adherence. In fact, for Dialectical Behavior Therapy, consultation is required to ensure that all therapists are adhering to the treatment manual (see here for more details). The last way of seeking support is related to work-life balance. Take the time to recognize if you are feeling therapist burnout. It can happen. Managing work/life balance and seeking consultation and peer support or advice can help. In the end. Batman recognizes his expertise and when he needs help. In clinical work, we need to be doing the same thing.
Lesson 5: Trust the data.
“Maybe it is time we stopped trying to outsmart the truth, and let it have its day.” – Alfred Pennyworth, The Dark Knight Rises (2012)
The final lesson that we can learn from Batman is to trust the data. At his core, Batman is a detective. Many in the DC universe call him The World’s Greatest Detective. He has degrees in criminal science, forensics, computer science, chemistry, engineering, biology, physics, and advanced chemistry and technology. When he is solving a mystery, he knows to trust in the latest available science and data. Additionally, he follows the clues and data he collects along the way to figure out who is behind whatever heinous crime he is working on at that time. He tries to keep his own personal judgment or emotion out of the equation and trusts in what he can observe, quantify, and measure.
The same ideals should hold true in clinical work. When comparing clinical judgment to statistical judgment, we know that the stats are at least as good, and often times better, than our own clinical judgment (see here for a great reading on this). Looking further, there are many researchers working hard to determine what the most empirically-supported interventions and assessments are. There is a range in the level of evidence available for different treatments. We owe it to our clients to select the treatment with the greatest statistical likelihood of working for each given disorder. If no single treatment stands out statistically, or if an empirically-supported intervention is not working, then we can adopt a hypothesis testing approach to treatment. By selecting a treatment that we have reason to believe will work and testing whether it is through an appropriate outcome measure, we can continue to move forward in a data-driven manner. Just like Batman trusts the data and science before his own judgment or conclusions, we as clinicians ought to as well.
Are you still here? Amazing. Because that post got much longer than I ever expected. At the end of the day, Batman is a character with over 75 years of content in comics, movies, video games, television shows, and novels. He’s a character who can fit the needs we have as readers or viewers. Today, we just wanted to think about some of the ways in which Batman might help guide us in clinical work. There are a lot of amazing fictional and non-fictional individuals who can guide us in any profession or life in general. Who are some that you look up to?