Should we try to be the keepers of our brothers and sisters?
PSYCHIATRIC VIEWS ON THE DAILY NEWS
“Am I my brother’s keeper?” - Cain
So answers Cain to God after murdering his brother Abel in the Biblical story. What we do not know is how their parents—Adam and Eve—raised and monitored them.
The same question could be asked to the Memphis police after seeing the released videos of Tyre Nichols. The question arises: who is to blame? At first view of the videos, the police officers who beat him toward death is the obvious answer, and they were fired right away.
However, a question arose fairly soon as to how well those police officers were supervised, both in the past and during the episode in question. That they were a relatively new and special unit called Scorpion, designed to respond to high-risk situations, seemed to call for adequate supervision.
Anyone trained in psychiatry has likely become familiar with the importance of supervision. Just wanting to help is not a guarantee of being a good helper. Us helpers, depending on our motivation for the career, can try to do too much or too little to help. How well do we handle frustration, with empathy or anger? Watching and addressing this challenge is called countertransference, or how our own child development, implicit bias, and vulnerabilities may be triggered by the patient. How well can we stay cool in a crisis, whether that is a societal, homicidal, or other crisis? If on a team, how well does the team work together or fall prey to regression and group think?
Supervision implies taking responsibility for the less experienced and knowledgeable supervisees. Although usually required during training, supervision in psychiatry is optional afterwards, at least in private practice. In a system of care, supervision can be required. Quality of care is at stake, as has been documented in managed care systems.1
Parents, like in the Cain and Abel story, have supervision responsibility, at least until their children’s adulthood. How and when to appropriately and gradually pull back supervision is an essential and ubiquitous challenge.
But where does supervision end? Who supervises the supervisors or the heads of systems and governments? Can’t psychiatric supervision be helpful to the police and other helpers?
There is beginning talk about Tyre Nichols and how he can be honored by bettering policing. Even more than that, effective supervision is needed in much any human helping endeavor. We all must try to be the keepers of our brothers and sisters, meaning all humans, for, on our own, human nature and history puts us at continued risk for harming one another.
Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times™.
1. Moffic HS. The Ethical Way: Challenges & Solutions for Managed Behavioral Healthcare. Jossey-Bass; 1997.