What can we learn about therapy, evidence and the risks of misdiagnosis from a 1957 courtroom film classic?
Hearing the Evidence, Hearing the Client
First of all, if you haven’t seen the movie 12 Angry Men, and you want to, please stop and come back when you’re ready, because there will be spoilers.
The film begins as a jury retires to deliberate a case. A young man is accused of murdering his father and the prosecution has stacked up an impressive pile of evidence. There was an eyewitness to the murder itself, another man who saw the accused fleeing the scene, a murder weapon, and a credible motive.
With all the facts on the table pointing at the accused, it comes as a surprise when soft-spoken Juror #8 (Henry Fonda) begins to express his doubts as to exactly how open-and-shut the case might be.
Hearing clients in therapy can be a lot like serving on a jury. Even though sessions usually last only fifty minutes, therapists can unearth a surprising amount of ‘evidence’, especially in early sessions. As in a real trial, people take sides. Sometimes the client is intent on ‘clearing his or her name’ by demonstrating that there really isn’t a problem that needs to be addressed. Other clients will indict themselves more savagely than even the most vicious district attorney. A good therapist steps in as the ‘judge’, not to render judgement or justice, but to keep the playing field level by maintaining the right combination of compassion, interest, and detachment.
Returning to the movie, at first, all of the remaining jurors are incensed at number eight’s reluctance. They want to go home, to a ball game, or do anything else than stay cooped up in a small room in the middle of the summer with no air conditioning. Tempers flare as jurors’ intelligence and common sense are questioned. At moments, it seems like a fight is going to break out.
In therapy, there is also time pressure on the therapist. In addition to the 50-minute hour, which we’ve already discussed, health insurance won’t pay for treatment unless a diagnosis (a verdict) and a treatment plan (a sentence) are rendered in short order. Meanwhile the clients (through no fault of their own) may be accelerating the rush to judgement. The clients want to know what’s wrong with them and how they can fix it, and they want to know right now. Finally, therapists themselves may increase the pressure. If a likely and clever hypothesis springs to mind, it is torture not to blurt it out. If no such theory arises, the therapist may begin to start asking “what’s wrong with me that I’m taking so long to get to the bottom of this case?”
The Lure of the Most Likely Answer
As the jurors of 12 Angry Men sift through the evidence again and again at Juror #8’s gentle insistence, they begin to reveal flaws in seemingly airtight testimony and exhibits. Even jurors who are willing to accept these new flaws still point out that they don’t even begin to compare to the remaining mountain of facts that point to the defendant’s guilt. “If we have to pick a theory, let’s pick the one with the most evidence” they explain.
However, any legal scholar worth his salt will tell you that “the leading theory” is not good enough to convict anyone of murder under U.S. law. The prosecution must prove the case “beyond a reasonable doubt.” Juror #8 is looking for reasonable doubt, and he is beginning to see it.
For therapists invested with the power to diagnose, we cannot avoid ‘passing judgement’ on clients. Every diagnosis changes how we see the client and, more profoundly, how clients see themselves. A diagnosis may affect clients’ prospects for finding work, or getting health coverage, or maintaining relationships. My wish for those who diagnose is that they too have a higher standard of evidence than ‘whatever is more likely’ when they pronounce their diagnosis.
Back in the jury room, with temperatures and tempers flaring, jurors were turning to more than just evidence to make up their minds. While we would like to believe that jurors all make up their minds independently and render 12 independent reckonings of guilt or innocence, robust research on group dynamics reaches exactly the opposite conclusion. Far more often than not, an individual who is part of a larger group will agree with the group’s decision even when the individual is quite sure they are wrong.
Therapists form their own groups as well. A major component of counselor training in my area is called ‘supervision,’ which often amounts to getting together in a group and trying to reach consensus on cases. In my own experience, even when the ground rules are set up to encourage debate and difference of opinion, it is a real trial to speak against another clinician’s viewpoint even if it diverges massively from my own.
Being Juror #8
Henry Fonda’s Juror #8 is the hero of 12 Angry Men not because he’s bold or daring, but because he’s softly, quietly brave in a much harder arena: the struggle against haste, easy answers, and ‘group think’. Over and over, he steers around the temptation to ‘win’ arguments and instead keeps asking humble questions that reveal holes in a seemingly airtight case.
If a therapist could adopt Juror #8’s traits, I don’t think it would guarantee he’d make good diagnoses every time, but he could at least steer clear of bad diagnoses or premature diagnoses. And whether he was wrong or right, the client would know for a fact that he had heard everything the client had to say and looked at it from every angle. Sometimes just being heard fully is the best treatment available.
All clinical material on this site is peer reviewed by one or more clinical psychologists or other qualified mental health professionals. This specific article was originally published by Dr Greg Mulhauser, Managing Editor on .on and was last reviewed or updated by