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MY PHOTO JOURNEY MY THERAPY JOURNEY Sophistication (Mastery)

Through the Lens of Trust: The Ethical Challenges of Photographing Your Own Children

This post is based on one originally written in 2017 as part of my private reflective journal following an intriguing exchange with a couple of students on an MA in Photography. It was posted there in June 2017, just four months before Harvey Weinstein was first accused of sexually abusing female staff and clients of his. I have edited and added to it, but some of the references are now seven years old.

I don’t seriously believe that anyone can not be aware that there are concerns that the modelling profession is potentially highly exploitative, and that in trying to survive within it many models have been abused; whether this is overt sexual exploitation (the Directors’ couch) or indirectly related to body-image (especially leading to eating disorders). This year alone [2017] has seen meta-analyses related to thinness standards (Rodgers, et al, 2017) and similar concerns among the physical trainer community (Fernández-Balboa & González-Calvo, 2017).

Within documentary photography, and especially in the street-photography genre, there’s a widely accepted (in the majority of countries) principle, that someone in a public place has to accept that their image may be captured, and that the resulting photograph may be published, potentially for the financial gain of the photographer. However, it is also widely accepted that these photos may not be used for commercial purposes, and especially not to imply that the subject (the model) is endorsing a product, service, or brand. Doing so, would constitute abuse.

If adults are prone to these issues, then we have to be particularly concerned about children. In the UK, individuals are defined as children if they are under 18, though in certain circumstances for protection purposes, this extends to “at least 21” and therefore potentially beyond. Rather naive lay-people consider abuse to involve physical violence or be sexual in its nature. The NSPCC recognises 12 different forms of child abuse.

With children, whose brains are still developing (until their mid-20s, even) it is now known that even quite mild forms of neglect and emotional abuse (known professionally as ‘childhood adversities’) can lead to serious psychiatric conditions in adulthood – in particular schizophrenia and bipolar disorder – and we are rapidly reaching concensus as to the neurochemical basis of this (Aas, et al, 2017).

With the advent of Facebook, there are a growing number of children whose parents regularly post images of their children as they grow up. While these images might previously have been filed away in a photo album, today they are distributed widely for friends (and if the privacy settings are not used to otherwise restrict them, with the general public worldwide). There has already been one case of a child sueing her parents for the invasion of privacy that this represents (http://www.independent.co.uk/news/world/europe/teenager-sues-parents-over-embarrassing-childhood-pictures-on-facebook-austria-a7307561.html).

Children (especially young ones) cannot make decisions on their own. They rely on those they trust to help them do so. Of course, most parents at various times will gently manipulate their children’s decisions in the parents’ favour. Persuading a child to eat all of its food, or to go to bed at a given time, not to use their computer at certain times, and so on, are all deemed normal child raising.

If a parent is a keen photographer, whether amateur or professional, they are likely to encourage their children to pose for their photographs to be taken. That ‘encouragement’ very easily slips into a message of conditional love, which is the foundation of emotional abuse. This is not about anything being done to them, it is about the sense that they will be loved just a little bit more if they engage, and a little bit less if they do not.

The American photographer, Sally Mann, has always been regarded as controversial by many people because of the extent to which she documented her children until puberty. Her youngest daughter described her feelings when her mother stopped doing so and began to work only on landscapes, as feeling as though she had been deserted. The two girls both associated the taking of the photos as a demonstration of their mother’s love for them; that they drew this conclusion clearly suggests that they did not get the same strength of love from other activities. Sally Mann’s son committed suicide in 2016, having suffered from schizophrenia all through his adult life. One of her daughters became a substance abuser as an early teenager, dropped out of high school, and was sent to a boarding school thereby removing her from the domestic environment. Mann herself was extensively photographed by her father as a child, and reports that she has blocked her memory of her childhood almost completely – a classic symptom of abuse.

In this digital age, though, the issues don’t stop there. A child cannot possibly be expected to understand the potential consequences of their pictures being seen by a wider audience. They depend on the person they trust to inform them in this respect. If the parent is the photographer, and their livelihood depends on the sale of those images, then I find it hard to see how this is likely to lead to neutral or trustworthy advice. This situation is bad enough when the parent depends on the income from their child and registers them with a modelling agency, but when they are the photographer and seller any possibility of objectivity is surely lost. While Facebook has guidelines in place regarding nudity, these images need not be of the naked child. The abuse is in letting the child believe that they will be loved more if they allow themselves to be photographed. Children don’t say this. Asking how they feel is meaningless as they don’t have the emotional maturity to know. They probably don’t know how they feel and won’t for many years. This is not a question of the process by which they are engaged in the photo-making itself – it is about their sense of themselves, of their self-esteem, and how (in years to come) they feel about the experiences.

As a psychotherapist, I am very aware that most people’s ‘issues’ relate to childhood events and family dynamics, and how they perceive them. As James asserted in the title of his book, “they fuck you up” [your parents] (James, 2006)

So, where does this all lead?

REFERENCES

Aas, M., Dieset, I., Hope, S., Hoseth, E., Mørch, R., Reponen, E., … & Agartz, I. (2017). Childhood maltreatment severity is associated with elevated C-reactive protein and body mass index in adult with schizophrenia and bipolar diagnoses. Brain, behavior, and immunity.

Fernández-Balboa, J. M., & González-Calvo, G. (2017). A critical narrative analysis of the perspectives of physical trainers and fitness instructors in relation to their body image, professional practice and the consumer culture. Sport, Education and Society, 1-13.

James, O (2006) They F*** You Up: How to Survive Family Life (2nd Ed). Bloomsbury.

Rodgers, R. F., Ziff, S., Lowy, A. S., Yu, K., & Austin, S. B. (2017). Results of a strategic science study to inform policies targeting extreme thinness standards in the fashion industry. International Journal of Eating Disorders, 50(3), 284-292.

UPDATE (19/01/25)

In early January 2025, the Dallas Fort Worth Police executed a warrant to secure images of Mann’s children on display at the Fort Worth Modern Art Museum, on the grounds that they were alleged to be child pornography. This is not the first time that such concerns have been expressed, as they were back in 1995 soon after they were taken. However, it will be interesting to see whether the tide has changed on the popularity of Mann’s work.

Inside The Vexing Past Of Photographer Behind The Fort Worth Modern Art Museum’s Offensive Exhibit

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MY THERAPY JOURNEY PURE BLOG

When your doctor believes in a God…

The influence of supernatural beliefs on clinical decision-making among medical practitioners raises significant concerns regarding the application of critical thinking in healthcare. Evidence suggests that when practitioners allow their beliefs in supernatural entities to guide their clinical choices, they may not be employing a rational, evidence-based approach to patient care.

Research also indicates that beliefs in supernatural phenomena can lead to cognitive biases that impair critical thinking. For instance, Bouvet highlights that non-reflective thinkers are predisposed to attribute supernatural causation to uncanny experiences, suggesting that such beliefs can emerge from personal experiences rather than rational analysis (Bouvet, 2015). This phenomenon can be particularly problematic in medical settings, where decisions should ideally be based on empirical evidence and scientific reasoning rather than subjective beliefs.

Furthermore, the cognitive science of religion provides insights into how supernatural beliefs can arise and persist. For example, Maij et al. discuss how cognitive biases may contribute to the formation of beliefs in supernatural agents, indicating that these beliefs are not necessarily grounded in critical evaluation but rather in innate cognitive tendencies (Maij et al., 2017). This suggests that practitioners who hold such beliefs may be less likely to engage in the rigorous analysis required for effective medical decision-making.

Moreover, the implications of supernatural beliefs extend to broader societal contexts, where such beliefs can influence behaviours and attitudes. Shariff and Rhemtulla’s study on the effects of beliefs in heaven and hell on crime rates illustrates how supernatural beliefs can shape moral reasoning and decision-making in ways that may not align with evidence-based practices (Shariff & Rhemtulla, 2012). This raises concerns about the potential for similar influences in clinical settings, where a practitioner’s belief in supernatural entities could lead to decisions that prioritize spiritual considerations over medical evidence.

Additionally, the prevalence of supernatural beliefs among practitioners can create a disconnect between their clinical responsibilities and their personal convictions. For instance, Martinez et al. explore how beliefs in supernatural evil can lead to risk management strategies that may not be scientifically justified, suggesting that such beliefs can introduce unnecessary layers of complexity into healthcare decision-making (Martinez et al., 2017). This is particularly concerning in fields like psychiatry, where evidence-based approaches are crucial for effective treatment.

Summing up, the evidence indicates that when medical practitioners allow supernatural beliefs to influence their clinical decisions, they may compromise their ability to apply critical thinking effectively. The reliance on beliefs that lack empirical support can lead to decisions that are not aligned with best practices in patient care. Therefore, it is essential for healthcare professionals to recognize the potential impact of their beliefs and strive to base their clinical decisions on scientific evidence and critical reasoning.

Follow up

I have been challenged that the work cited above does not specifically address the behaviour of physicians.

Curlin et al (2005), reported that a significant percentage of US physicians believe their religious beliefs influence their medical practice, indicating a widespread acknowledgment of the interplay between faith and clinical decision-making.

Moreover, the attitudes of physicians towards sensitive issues such as abortion and euthanasia are also influenced by their religious beliefs. For instance, Marván et al (2012) found that gynaecologists with strong religious convictions were more likely to view elective abortion negatively, reflecting the impact of religious doctrine on clinical ethics and decision-making.

Similarly, Broeckaert et al (2009) noted that palliative care physicians who actively practice their faith tend to be more critical of euthanasia, suggesting that personal beliefs can shape ethical stances on complex medical issues.

Bibliography:

Balboni, T., Balboni, M., Enzinger, A., Gallivan, K., Paulk, M., Wright, A., … & Prigerson, H. (2013). Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life. Jama Internal Medicine, 173(12), 1109. https://doi.org/10.1001/jamainternmed.2013.903

Borges, M., Lucchetti, G., Leão, F., Vallada, H., & Peres, M. (2021). Religious affiliations influence health-related and general decision making: a brazilian nationwide survey. International Journal of Environmental Research and Public Health, 18(6), 2873. https://doi.org/10.3390/ijerph18062873

  • Based on a large scale survey of Brazilians, this was a comprehensive review of the influence of religious belief on individual’s decision making. Of interest to us, concerning health-related decisions, the influence of religious affiliation was high on accepting medical recommendations (45%) and on refusing medical advice (22.6%).

Bouvet, R. (2015). Non-reflective thinkers are predisposed to attribute supernatural causation to uncanny experiences. Personality and Social Psychology Bulletin, 41(7), 955-961. https://doi.org/10.1177/0146167215585728

Broeckaert, B., Gielen, J., van Iersel, T., and d. Branden, S.V.. (2009) ‘Palliative Care Physicians′ Religious / World View and Attitude Towards Euthanasia: A Quantitative Study Among Flemish Palliative Care Physicians’. Indian Journal of Palliative Care 15, no. 1: 41. https://doi.org/10.4103/0973-1075.53511. [Alternative source: https://pmc.ncbi.nlm.nih.gov/articles/PMC2886213/]

  • A particularly significant topic at the present, the researchers showed that physicians who have a strong belief in God and express their faith through participation in prayer and rituals, tend to be more critical toward euthanasia. Physicians who deny the existence of a transcendent power and hardly attend religious services are more likely to approve of euthanasia even in the case of minors or demented patients.

Curlin, F.A., Lantos, J.D., Roach, C.J., Sellergren, S.A., and Chin, M.H.. (2005) ‘Religious Characteristics of U.S. Physicians’. Journal of General Internal Medicine 20, no. 7: 629–34. https://doi.org/10.1111/j.1525-1497.2005.0119.x.

  • Fifty-five percent of physicians say their religious beliefs influence their practice of medicine. Compared with the general population, physicians are more likely to be affiliated with religions that are underrepresented in the United States, less likely to say they try to carry their religious beliefs over into all other dealings in life (58% vs 73%), twice as likely to consider themselves spiritual but not religious (20% vs 9%), and twice as likely to cope with major problems in life without relying on God (61% vs 29%).

Curlin, F., Chin, M., Sellergren, S., Roach, C., & Lantos, J. (2006). The association of physicians’ religious characteristics with their attitudes and self-reported behaviors regarding religion and spirituality in the clinical encounter. Medical Care, 44(5), 446-453. https://doi.org/10.1097/01.mlr.0000207434.12450.ef

  • Controversy exists regarding whether and how physicians should discuss or share religion/spirituality (R/S) beliefs with patients and pray with them. This study examines the relationship between physicians’ religious characteristics and their attitudes and self-reported behaviours regarding R/S in the clinical encounter.

MacLean, C., Susi, B., Phifer, N., Schultz, L., Bynum, D., Franco, M., … & Cykert, S. (2003). Patient preference for physician discussion and practice of spirituality. Journal of General Internal Medicine, 18(1), 38-43. https://doi.org/10.1046/j.1525-1497.2003.20403.x

Maij, D., Harreveld, F., Gervais, W., Schrag, Y., Möhr, C., & Elk, M. (2017). Mentalizing skills do not differentiate believers from non-believers, but credibility enhancing displays do. Plos One, 12(8), e0182764. https://doi.org/10.1371/journal.pone.0182764

Martinez, B., Tom, J., Ferguson, T., Andercheck, B., & Stroope, S. (2017). Parenting practices and attitudes and the role of belief in supernatural evil: results from a national US survey. Journal of Family Issues, 39(6), 1616-1638. https://doi.org/10.1177/0192513×17720757

Marván, Ma.L., d. Río, A.A., and Campos, Z.. (2012) ‘On Abortion: Exploring Psychological Meaning and Attitudes in a Sample of Mexican Gynecologists’. Developing World Bioethics 14, no. 1: 29–36. https://doi.org/10.1111/dewb.12005.

  • Elective abortion has become an issue of political debate. This study explored the psychological meaning and attitudes toward elective abortion of Mexican gynaecologists. Words most frequently used by participants implied a negative sanction. There were important differences by gender and religiosity: male gynaecologists, as well as those with strong religious beliefs (mainly Catholics), revealed a more negative attitudes than females or physicians with weak religious beliefs.

Menegatti-Chequini, M., Maraldi, E., Peres, M., Leão, F., & Vallada, H. (2019). How psychiatrists think about religious and spiritual beliefs in clinical practice: findings from a university hospital in são paulo, brazil. Brazilian Journal of Psychiatry, 41(1), 58-65. https://doi.org/10.1590/1516-4446-2017-2447

Shariff, A. and Rhemtulla, M. (2012). Divergent effects of beliefs in heaven and hell on national crime rates. Plos One, 7(6), e39048. https://doi.org/10.1371/journal.pone.0039048

Yoon, J., Shin, J., Nian, A., & Curlin, F. (2015). Religion, sense of calling, and the practice of medicine: findings from a national survey of primary care physicians and psychiatrists. Southern Medical Journal, 108(3), 189-195. https://doi.org/10.14423/smj.0000000000000250

  • Surveyed primary care physicians and psychiatrists, and overall between 45 and 60% depending on their particular Faith, considered that they had a religious calling (not merely a vocation, which could be for a variety of secular reasons) to do this kind of work.