Your neighbor gives you a funny smile as she clips her hedge.
You look up from your Big Mac and notice a fellow toting a pistol, a shotgun and a semiautomatic rifle.
In each of those encounters, you might catch yourself wondering whether the person in question is dangerous. If you're lucky, someone may already have made that determination. If you're very lucky, the person doing the determining did a good job.
Predicting violent behavior is becoming increasingly important and increasingly controversial as society becomes increasingly violent, according to specialists on psychology and the law.
About 60 psychiatrists, psychologists, marriage counselors, nurses, attorneys and other professionals gathered Saturday at UC Irvine to hear two panel discussions of "Dangerousness: Legal and Clinical Aspects." The group got a detailed look at its members' complex legal and professional responsibilities and the clear message that how they and their colleagues handle those responsibilities concerns everyone.
As attorney Byron Chell, former chief counsel to the state Department of Mental Health, explained, the legal and ethical quagmire that therapists face dates back to a 1976 California Supreme Court ruling. Known simply as "Tarasoff," that ruling offers insight not only into the dilemma of therapists but also into society's growing concern with what had traditionally been deemed the sacred domain of client-therapist confidentiality, speakers explained.
According to various accounts of that case, in 1969 Prosenjit Poddar, who had voluntarily sought outpatient therapy at UC Berkeley's Cowell Memorial Hospital, told a psychologist about violent fantasies he had concerning Tatiana Tarasoff, a young woman with whom he had become obsessed. Poddar's therapist consulted with a psychiatrist on the hospital staff, and they decided that Poddar should be hospitalized under California's new civil commitment statute.
The psychologist wrote to the university police, and officers interviewed Poddar at his apartment. But instead of committing him, they left him with a warning to steer clear of Tarasoff. Two months later, Poddar stabbed the young woman to death.
"You can imagine how the family felt," Chell told the group. "Suppose this is your daughter. . . . (Poddar) went to see therapists and let them know he was going to kill your daughter . . . then the police let him go."
The family reacted with a lawsuit charging the therapists and the campus police with negligence. University attorneys, in turn, claimed that neither party in the case had a duty to protect or warn Tarasoff. The Supreme Court disagreed and established, for the first time, that therapists had a legal duty to warn an intended victim.
Panelist Robert Sullivan, counsel to the California State Psychological Assn., said he understood the pressure that therapists sometimes feel. "My father was a psychiatrist, and I remember he'd have white knuckles and beads of sweat at night when he'd get calls from people threatening suicide or threatening to kill someone else."
The pressure on therapists increased with the Tarasoff decision, and a series of related cases have put them in more of a bind, Sullivan said. In one of those decisions--the Hedlund case--therapists' legal duty was broadened to include liability not only for the person actually threatened but for other people injured in an attack on the threatened person. In another ruling--the Jablonski case--therapists were found to have a duty to predict or diagnose violent behavior, even though no specific threat was made. In the spring, 1984 issue of California Health Law News, Chell wrote: "It can be argued that Jablonski has quickly taken the 'duty to warn' from the land of therapeutic reality to the wonderland of clairvoyance."
According to Sullivan, though, a recent statute may signal a change in that tide of decisions. Many of the therapists gathered expressed relief that their responsibilities seem to have been more clearly defined by California Assemblyman Alister McAlister's Assembly Bill 1133--which was passed last year after strong lobbying by the California Psychiatric Assn. But that law, which requires a therapist to "make reasonable efforts to communicate the threat to the victim or victims and to a law enforcement agency" and provides that a therapist is immune from liability "except where the patient has communicated to the psychotherapist a serious threat of violence against a reasonably identifiable victim," is open to broad legal interpretation, panelists said.
Professionals at the daylong seminar ranged from a Long Beach radio psychologist concerned about his liability for advice given over the air, to sheriff's deputies, psychiatric social workers and a Riverside attorney who believed her client had been falsely committed for voicing a vague and meaningless fantasy to his therapist.