CHAPTER TWO
NON-CLINICAL PSYCHOLOGISTS
COMMANDANT ANDRIES K.
Commandant Andries K. was the overall head of the Psychology Department from the time that I presented for interview for the Clinical Internship in August 1985. He is mentioned in 'Grensvegter?' (Chapter 1). In 1985 I knew a psychologist who had completed his national service at 1 Military Hospital, and who advised me that Commandant K. had great difficulty in closing off meetings.
I met with him socially in the evening following my interview, and I think driven by a need to make conversation, I asked him how, as a senior psychologist, he managed to keep himself up to date with all the reading that, as psychologists, we are required to do to keep ourselves 'up to date'.
I quite liked his answer; "Read an article, and allow yourself to be influenced by it. Then discard the article, but allow its influence on you to remain." It seemed a sensible answer at the time, but it is not a method I follow five years later.
ED: Is it possible that I might have misunderstood the following anecdote?: Commandant K. blew his credibility in my eyes shortly after I started work at 1 Military Hospital. In a discussion about the poor pay of psychologists (relative to doctors, I presume), he said: "How can a psychologist relate to a patient who is hungry when the psychologist is hungry himself." That struck me as ridiculous, because, although we earned less than doctors (and had less responsibility), we were by no means poor, and were significantly better paid than nurses.
THE COUNSELLING PSYCHOLOGY DEPARTMENT
The Counselling Psychology Department consisted of:
MAJOR `OLLIE' O.
CAPTAIN WILMA B.
CAPTAIN ZAAN E.
CAPTAIN NAAS R.
CAPTAIN JOHAN A.
CAPTAIN DEON C.
Intern: MRS. PAT C.
MAJOR 'OLLIE' O.
'Ollie' was a friendly person, but very dogmatic in some areas; he was a 'Systems Worker', and seemed to insist that staff in his department followed a 'Systems Approach' in their work. He seemed to very involved in the career structure of psychology in South Africa.
CAPTAIN WILMA B.
Early in 1986 we had a departmental meeting at which the "Total Onslaught" propaganda against South Africa was discussed. Wilma, rather naively I thought, then asked why South Africa did not put out more positive propaganda to counter the total onslaught! This was well after the discovery that the government had used public funds to finance a party mouthpiece, the 'Citizen' newspaper. I don't remember what answer she was given.
At a staff development lecture on gynaecology, mention was made of a condition in which women experience a constant orgasm. "Oooh," said Wilma. "How does one catch that?" Brilliant!
CAPTAIN ZAAN E.
Zaan was a pleasant enthusiastic woman, but a woolly thinking 'family therapist' - see the 'Cobie' case in Chapter 11. I was aware of her mustering around to find people to do the 'therapy work' so she could supervise them from the safety of being behind the one way mirror.
CAPTAIN NAAS R.
Naas was a very quiet and friendly person, whom I got to know better in 1987 when we were both working in the New 1 Military Hospital. Naas had done national service before going to university, and he had spent his time at Palaborwa Infantry Camp, 7 SAI. He had experienced the army from the sharp end.
CAPTAIN JOHAN A.
I don't know whether I took an immediate dislike to Johan A., or whether I was just unimpressed with him, and didn't see much of him to change my impression of him.
He was a very self-opinionated person. I sat at the same table as him at lunch in the mess one day in 1987. An intern, young and impressionable, came and sat with him, and Johan A. started to lay down the law about how little effort was actually required to write a masters thesis. He suggested that all that was required was to run a group for a while, and then to write up the experience. I doubt that the university from which he had graduated would have been impressed with this view.
I mentioned this to someone who was more sympathetic to Johan A., probably Naas. Naas tried to defend him, rather half heartedly, saying that Johan A. 'was not academic'. Psychologists, holding masters' degrees, are supposed to be academic.
Barron's (1989) article suggests that Johan A. is now head of psychology at 1 Mil. (Have I added this as a jibe to prove how academic I am?)
CAPTAIN DEON C.
Deon started national service at the start of 1986, but joined the permanent force almost immediately. He features in greater depth in the last chapter of 'Grensvegter?'.
MRS. PAT C.
Pat, the Counselling Psychology intern in 1986, was a mature student, who had a family of teenage children. Early in the year, her family moved down to Natal, six hours drive away. Pat lived in the Officers Mess during the week, and went down to her family on most weekends. We all had a great respect for this dedication that she placed in doing her internship.
Pat mixed in the same clique as I did in the mess, so more attention will be paid to her in the 'Mess' section of this project.
With her age, and her civilian status, we were amused at the various titles that were innocently given to her. These included 'Doctor' and 'Major'. I think that she felt most comfortable with 'Mrs.'!
THE MEDICAL PSYCHOLOGY DEPARTMENT
The Medical Psychology Department consisted of:
MAJOR COETZEE B.
CAPTAIN ELFRIEDA P.
LIEUTENANT TREVOR R.
LIEUTENANT ALAN C.
MAJOR COETZEE B.
Coetzee was the person that I had the most to do with before I started my internship at 1 Mil. It was he that arranged my interview for the internship, and he invited me to stay with him and his wife for the couple of days that I spent in Pretoria around my interviews.
He was a large man, tending to be fat. He ranged from being considerate to inconsiderate, and was generally considered to be unreasonable and unpredictable at times.
He has a surprising English slant to his upbringing - he had been a Boy Scout if I remember correctly. He had also had some major medical problems when he was of student age, from which he developed his particular interest in medical psychology, looking specifically at pain management and coming to terms with mutilations.
We wrote an article for 'MilMed', the Journal of SAMS, in which he documented some amusing anecdotes relating to psychological patients in the army - possibly something like a very condensed version of this project!
CAPTAIN ELFRIEDA P.
It must be said that she was like a human 'Barbie Doll', tall slim and blond, and good looking. There was something of a 'dumb blond' image that surrounded her, though I don't think she was stupid.
It was rumoured that she had a lucrative private practise in the evenings, and that she saved most of her energies for that and avoided doing much clinical work during her working days. This was quite evident, and Dr. Les K., while on a camp in late 1987 innocently asked if she was working part time!
Elfrieda is a very good marksman - marksperson - a sport to which she devoted her Wednesday afternoons. She won a variety of trophies, and might even have been a Springbok shotist.
A story which I remember only vaguely was of Elfrieda, wearing her uniform in some public place like a library, meeting up with someone in civilian dress, who let it be known to her that he was General Such-and-such, lets call him 'Redelinghuis' for the story. Why would he do that? To show off, by getting 'the blond bombshell' to honour him militarily by saluting him? Such things are important to some people!
She didn't believe him, saying the equivalent of; "No you're not. I know General Redelinghuis, (probably from shooting) and you don't look a bit like him."
But he was another 'General Redelinghuis', and he took it upon himself to complain, him having the advantage of being able to read her name and her rank and the fact that she was in the SAMS from her uniform. Elfrieda was reprimanded for incident, but I don't think anyone took it all that seriously, apart from the other 'General Redelinghuis.'
LIEUTENANT TREVOR R.
Trevor did his National Service first, and then joined the Permanent Force in late 1986, and became a Captain. Although English speaking, he had trained at Rand Afrikaans University. He had a particular interest in closed head injuries, and was doing his Ph.D. in the subject.
A gimmick that he played around with was pretending that he had an imaginary companion, called Fred (If I remember correctly), from whom he would pass messages to me, and whom he would consult. It was quite an amusing act, but he laboured it sometimes.
LIEUTENANT ALAN C.
Alan was English speaking, from an English University, finished his National Service at the end of 1986, and I don't think the idea ever passed through his mind of joining the Permanent Force.
Alan occasionally mixed with my clique in the Officers' Mess, where he fitted in well, without ever becoming 'one of the gang'. He had a very sharp wit, and could tell stories well. He told of how he had dealt with a session during which a patient had refused to say anything. Many psychologists feel that, rather than turf such a patient out of your office, telling him to come back when he's ready to speak, you should 'ride out' a silent session with them. Alan said that he used that silent time productively, and that he "planned all his holidays for the next seven years."
At one time, Alan had been offering the psychology service to the Obstetric and Gynaecology. He told a story of how one new mother had burst into tears with him, saying that she had felt fine until she saw the psychologist, but now she felt terrible.
THE CULTURE OF THE PSYCHOLOGY DEPARTMENT
There was a very macho chauvinist atmosphere in the psychology department. This was much less evident, if it existed in the department of Psychiatry (and subsidiaries) because there were far fewer women around.
To be in the inner circle of the Psychology Department, one had to play golf, and this could be done during work hours, on Wednesday afternoons, when there was a 'sports parade', and services throughout much of 1 Mil seemed to grind to a halt. What a cushy life!
There was also something called 'The Journal Club', to which only the male members were invited, and this was rumoured to be just a justification for the men to get away from their wives and go drinking. I didn't get involved, so I don't have any first hand information.
In 1986 there were five interns, four of whom were civilians. In 1987, special arrangements were made for 1 Mil psychologists who were registered as Counselling Psychologists to do Clinical Internships, and so to register as Clinical Psychologists. They had the advantage of being on full pay while doing so, while civilian interns, as I had been in spite of having qualified as a Counselling Psychologist, were paid about half what qualified psychologists were paid. It seemed that they would routinely qualify as Clinical Psychologists while going about their ordinary work. It wasn't a big deal really, as they were doing appropriate work, but it was very convenient for them. I suppose I was jealous!
The motivation to move from Counselling to Clinical Registration is one of status. While in fact there is much overlap between the two categories, and the training is as long for each, Clinical has the higher status, as reflected by medical aid being willing to pay for clinical psychology services, but not for counselling psychology services. (This may have changed in recent years!)
At the end of 1986, we had an end of year party/farewell party for those members of the department who were leaving. The party was held at a small restaurant, which we booked for the evening. The theme was 1950's, as being the decade in which most of us were born. At the tail end of the party, much fuss was made of the idea that all the members would be 'given gifts'. (Wink wink nudge nudge!) These were divided into male and female gifts. The women, I think, received sachets of perfume, while the men opened their presents to find a handful of condoms drop onto the table in front of them. That was a bit chauvinistic, wasn't it?
PSYCHOMETRICS
'Psychometrics' is the blanket name for all psychological tests, including IQ, diagnostic, personality, neuropsychology and vocational guidance.
INTELLIGENCE TESTING
We did IQ tests on some recruits where their intellectual ability was in question. The average IQ score is 100. People who scored an IQ of 75 or less were discharged from the army automatically. People with an IQ of between 76 and about 85 were generally sent to 1 Construction Regiment at Marievale just outside Johannesburg, where they were given some elementary basic training, and then used for their two years doing productive work in sheltered workshops.
It made sense to make special provision for the not so bright. There are limits to what some people can be taught, and safety is very important in an army that teaches people to use fire arms and other weapons of destruction - you don't want such material turned against your own side.
(Think of that scene from 'Full Metal Jacket' where that chap kills himself and the drill sergeant - that chap would most likely have been discharged from the SADF, though my impression that the character's IQ bounced around twenty points!)
Sometimes we tested people who plainly were not functioning in the military, but whose scores were not sufficiently low to arrange for them to be discharged. There is a psychiatric test for epilepsy called an EEG (Electroencephalograph), and one variation of this is a 'sleep deprivation EEG' where a person is likely to show epileptic brain activity if they haven't had any sleep.
I joked about the concept of doing 'sleep deprivation IQ tests', where people who had been deprived of sleep would have a lower IQ than they would have if they were rested, which would give us that all-imported score which would allow us to sort out the problem, in the best interests of all concerned. (To actually do so would have been very unethical!)
RORSCHACH
The Rorschach is the famous 'Ink Blot Test', much misunderstood by the general public. There are different methods with which the technique may be interpreted, and Glenn used a psychodynamic (Freudian) approach. According to this approach, there is a card which elicits sexual information.
Glenn was delighted when a patient with sexual difficulties said that he saw in the sex card; "A frog! ... A disgusting frog!"
MMPI & LIE SCALE
The Minnesota Multiphasic Personality Inventory gives ten scores of scales such as Depression, Hypochondriasis etc., but also gives some information about the manner in which the person took the test, one of which is popularly known as 'The Lie Scale'.
I saw a patient whom I believed had a serious problem. I wanted him to do a psychological test for me, but was worried that he might 'fake bad', in which case the results would indicate that he was making up symptoms, and might lead to him being distrusted completely.
After my assessment, I reported back to the panel that "I feel that the results of this test are valid. I told him to be truthful, because the test has a built in lie detector, which isn't strictly true." This brought the house down with laughter. Was I not being somewhat hypocritical?
We only had an English (American) version of the MMPI, but would use this occasionally with Afrikaans speakers whose English was good - this is a rather dubious practise:
"To test the hypothesis that this patient is faking good, the MMPI was administered, but Gert struggled to understand the English in the inventory, and the test was abandoned."
ACADEMIC ASPECTS OF 1 MIL PSYCHOLOGY AND PSYCHIATRY
I believe that 1 Mil was a training hospital; there were civilian trainee doctors wandering around, student nurses, and psychology students and interns.
The 1 Mil Psychology department had strong links with the University of Pretoria (Nicknamed 'Tukkies'), and their psychology masters students would attend specially laid on case conferences in the Psychiatry Department.
Accompanying the students was Professor Karel Kemp, an Afrikaans psychology-Guru, who was very dogmatic that he was always right. I comment in 'Grensvegter?' (Chapter 4) about the Afrikaans Universities following a concrete black-and-white 'there is one way to do it', while English speaking universities tend to provide a general flexible type of education. Would it be fair to make the distinction that Afrikaans Universities provide training while English Universities provide education?
Tukkies graduates are highly trained (like technicians) into a cookbook approach to most things - psychometry most obviously - where an intelligence test is seen as a vital member of a personality assessment, and Klopfer & Davidson's (1962) method of scoring the Rorschach is taken as the only way. At first I felt somewhat intimidated that my own Masters' degree had been much less structured and more vague, but I came to realise by not having an immediate A -> B -> C approach, I have more of an underlying understanding of the principals on which the psychometric instruments are based - possibly why I am cynical about most means of 'objective assessment', but I have less rigid thought processes than my Tukkies colleagues, and a greater tolerance of 'shades of grey' areas.
Tukkies advocated a fairly standard battery of personality tests, which were routinely administered. This was referred to as 'The Holy Trinity', and referred to the Thematic Apperception Test (TAT), the Rorschach Ink Blot Test, and one of the Human Figure Drawing tests - there are several. This 'Holy Trinity' seemed to be over-used, but psychology students generally find security in using so-called 'objective' techniques while they are building up their clinical experience, and 'professional intuition'.
The case conferences I attended were traumatic; Professor Kemp believed there was one right answer in all cases - his - and expected his students to come up with. They were too scared to open their mouths in case they got the wrong answer, so the case conferences were characterised, as I remember them, with questions being asked, followed by long silences.
Once the students were faced with an overhead transparency of a human figure drawing. "What do you make of this drawing?" Professor Kemp asked the huddle of students.
There was silence. Everyone waited for someone else to speak, and hoped that Professor Kemp would not name them and ask them what they thought.
Eventually one student took the plunge. "The legs look a bit phallic," she ventured hesitantly.
Glenn reported this to me gleefully later. "Of course legs look phallic," he chuckled. They're long and tubular!" We agreed that the student had been scraping the barrel.
I was from the University of Natal, and qualified as a Counselling psychologist, and so I was immune to the Tukkies hierarchically. They were very friendly to me, and invited me to attend some of the training days which were arranged for my fellow interns.
As interns, we were the first line of supervision to Tukkies masters students who did placements at 1 Mil. I had a girl attached to me, Helen V.. She was good, but rather rigid in her thinking, I thought. She decided not to do a neurological assessment of a patient whose personality she had just assessed because she 'Did not want to over-test the patient.' I talked her out of that one!
I believed that she knew many of the answers to questions she asked me, and so tried to tease the answers out of her, rather than just tell her what I thought - possible a clash of the cultures of her and my universities!
Unfortunately she perceived this wrongly, and feedback was leaked to me that the students had felt that I was 'hard on them'. The answer was within her grasp. All I had to do was to guide her towards it. A pity she took it that way!
Published: 1 July 2000.
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