Paper short abstract:

In U.S. forensic psychotherapy, failures of empathy can be guides to therapeutic efficacy, and, in reverse, empathetic success may signal therapeutic failure, a situation we refer to as a "fallacy of care" as we ask what new ethical goals take empathy's place in the forensic therapeutic alliance.

Paper long abstract:

Contemporary person-centered psychotherapy typically considers empathy a requisite feature of the therapeutic alliance and, thus, effective treatment.  However, empathy relates to care in altogether different ways in the practice of American forensic psychotherapy, suggesting a variable, dynamic, and counterintuitive relationship to ethical practice. Specifically, in this context, empathy risks a failure of the therapeutic alliance. Based on clinical case studies in a New England state psychiatric hospital, we ask how empathy illuminates therapeutic efficacy through its shortcomings, such that successful deployment of empathy indicates therapy gone awry, and vice versa. This paper will contrast two genres of failure - logical and ethical - that constitute what we call the "fallacy of care."  A point of entry into medico-legal logics of the "therapeutic alliance,"  this condition also opens up spaces for alternative ethical languages and visions of care oriented to the concept of "radical genuineness."  As a psychologist and an anthropologist, we approach clinical orientations to failure as at once orienting possibilities for care and highlighting the unique conditions of U.S. American forensic psychology. Ultimately, we argue that in a forensic inpatient context, empathy's care fallacy indicates that empathy can serve as a guide to effective practice precisely in the contexts in which it is no longer a goal.