The Role of Values in Professional Licensing: The Resistance to Regulation

One day, a well-dressed, mature gentleman—one might be tempted to describe him as elderly, except he appears extremely vital and alert—walks into a psychotherapist's office for a first visit. After just a few brief exchanges, the therapist gets the impression that the gentleman is a socially adept, financially successful, educated professional, and a well-regarded member of the community. But all is not as it seems on the surface. This new patient “presents†with lingering complaints of vague malaise, and despite his apparent success, he reports having experienced long-term intermittent bouts of anxiety and fear stemming from threats that the therapist cannot be sure are real or imagined: Various people seem regularly aiming to put him out of business; family relatives are disrespectful, demeaning, and do not understand him. Moreover, there is an existential quality to his anxiety: As a younger, middle-aged man, although already successful, he changed his name legally because he felt it better suited his identity. In fact, he came close to changing his name twice again in recent years, but, after agonizing about it for a long time, could not make up his mind what to change it to; nothing seemed to “fit†well enough. The therapist surmised, however, that the patient was more concerned with the impression his name would make on potential business clients and competitors than with any genuine expression of his nature, and he seemed relatively unconcerned with maintaining his nominal family identification. It struck the therapist that his patient's insecurities were not in keeping with his considerable accomplishments in life. In fact, for an educated professional, the patient seemed to lack insight into his own character and values.