Comparison Analysis and Legal Argument: Unpacking the “Separate But Not Equal” Dynamic in Professions and Governance
The document “Diagnostic Privilege” by Adam O’Brien, PhD, LMHC, CASAC, offers a profound critique of the mental health landscape, revealing systemic pathologies that extend far beyond clinical diagnoses. It posits that the legal framework, particularly as it pertains to professional authority, has created a “separate but not equal” dynamic, where law often dictates over morally developed science, and citizens bear an implicit responsibility for a government that may not be directly responsible for them. This analysis will delve into these three critical arguments, supported by O’Brien’s work and the concept of implicit bias.
I. The “Separate But Not Equal” Dynamic: Medicine, Psychology, and the Law
The field of medicine and various psychology professions, such as Licensed Mental Health Counselors (LMHCs), have been rendered “separate but not equal” to the legal system through a historical process driven by power, control, and economic imperatives. This disparity is not accidental but a deliberate outcome of how “auxiliary professions”—including government, banking, lawyers, and insurance companies—have shaped the identity and viability of mental health professions.
Historically, LMHCs, despite their comprehensive education and training, were compelled to conform to a medical model to gain professional legitimacy and insurance reimbursement. Policymakers omitted the specific word “diagnosing” from the original LMHC charter, creating a legal distinction that, while seemingly minor, had profound implications. This omission, now exploited by other professions, highlights how the legal system, through its “bureaucratic rhetoric,” asserts power and dictates professional practice. The LMHCs’ educational and training standards were often equivalent to those of established professions like Social Workers, yet they were forced to “placate to the systems needs of power and control, instead of the clients and our own” need to survive.
This dynamic is a clear manifestation of implicit bias, where “deep state” professions (administrators, lawyers, lobbyists) maintain control and position themselves as sole providers, often at the expense of public well-being. The system’s “addiction to profits, power, and privilege” drives a “quantitative addiction” that prioritizes data, control, and financial gain over human well-being and moral justice. This creates a hierarchy where psychology, often perceived as a “soft science” and a female-dominated profession, becomes “beholden to the development… of other more male dominated professions”. As O’Brien notes, “When one profession can dictate—under threat of penalty—what another must do or learn, it reveals much about the quality of the relationship that exists between them,” underscoring the inherent inequality. As examples, COVID shutdowns, Great Barrington Declaration, and mandating trainings that psychology could write (e.g., child abuse reporter training). The legal system, from its “watchtower,” comfortably dictates what is “right” without having “direct lives on the line,” contrasting sharply with the “frontlines” of therapeutic and police work.
II. Moral Character Clauses: Immature Law vs. Morally Developed Science
Licensed professions in NYS bound by a “Moral Character Clause” are often forced to adhere to laws that are “immature and morally undeveloped,” even when these laws contradict “morally developed science.” This paradox is central to O’Brien’s reminder to follow the science, who argues that the legal system’s understanding of morality is fundamentally flawed and reductionistic due to Piaget, Kohlberg, and Erikson research and qualitative science.
The New York State licensure renewal form, for instance, includes a “Moral Character Clause” primarily focused on legal infractions, equating ethics with law. O’Brien contends that “law serves as the base of human understanding… We do not need ethics if we follow just laws, but the issue becomes when the laws are unjust… We don’t need laws or ethics if we have morals; ironically, they do need ethics because they do not have morals”. This highlights a critical distinction: morals are the “parent of ethics,” implying that ethics and ethical principles require maturation, often delayed by “moral trauma and the subsequential dissociative aftereffect” within the system.
Numerous examples illustrate this conflict:
- Children involved in High Conflict Divorce Court Proceedings: Because psychology has yet to fully define their terms (unconscious, addiction, and dissociation) and the law and policy is misinformed and procedures (e.g., no dissociation-informed care), observing that children (often traumatized) are put on the stand to settle what the law and their parents cannot, suggests that the system is so unaware of the traumas it causes.
- Psychedelics: Despite clear scientific and qualitative evidence of their medical and healing value, psychedelics were historically deemed to have “no medical value” and made illegal, only to be capitalized upon following recent legalization. This demonstrates how law, driven by implicit biases and self-interest, suppressed morally developed science.
- Addiction Definition: The Diagnostic Statistical Manual (DSM) lacks an operational definition for addiction, yet individuals are imprisoned for a “disease” that is, from a morally developed scientific perspective, “dissociation, which is predicated on trauma and stress responses that are normal responses to all-too-common events”. This legal and diagnostic failure reflects a system “addicted to not being the ones who are addicted”.
- COVID-19 Response: The failure of legal and psychological bodies (like the APA) to question medical recommendations for experimental vaccines or forced COVID shutdowns, which were contrary to U.S. federal law, exemplifies how “unjust laws and standards” stem from “unresolved trauma and an inability to think abstractly within the system”.
According to Kohlberg’s stages of moral development, law enforcement often operates at an “earlier stage of moral development” characterized by “obedience, compliance, and maintaining order,” rather than the “universal ethical principles” of higher moral development. Professionals who “blindly follow laws instead of the common sense or evidence from research” do so out of fear for their “health insurance, retirement, status quo, and ego,” becoming complicit in a system that prioritizes “safety and security” over moral integrity. This “positive addiction pathology” within leadership prioritizes titles and self-interest, leading to flawed conclusions and a “lack of moral deficit in the professional population”.
III. Citizen Responsibility for Government: The Implicit Contract
The argument that citizens are responsible for their government, even when the government is not directly responsible for them (as implied by concepts like Castle Rock, removal of religious exemption, or Equal Rights Amendment), stems from the idea that “We the people” have implicitly granted power to these systems, and therefore bear the responsibility to hold them accountable when that power is abused.
O’Brien asserts that “power belongs to the heart and will of ‘The People'”. Citizens have given government and bureaucratic systems “power and control because it gives people jobs,” but this power has been abused because too many career politicians are too busy creating their careers (e.g., ambition). The system’s “undiagnosed addictions and dissociative tendencies” lead to “disparity, separation,” and a focus on “labeling others as ‘the problem'” without engaging in necessary self-reflection. This is where the concept of parens patriae becomes relevant: if American citizens are implicitly treated as “incapable children of the State,” then it is time for citizens to “confront our ‘parents’ about how this legal fiction enables systemic abuse”.
Government workers, often choosing careers based on “safety and security,” may “obey and comply with what may be unfit and unjust laws” out of fear, even when aware of systemic abuses. This individual compliance contributes to a collective “mass psychosis” or “groupthink,” where dissociative and addictive processes are woven into the fabric of society (e.g., apophenia). The “exponential profiteering off of crises” by corporations and governments, such as during the Opiate Epidemic and COVID-19 pandemic.
The responsibility of citizens is to “help systems refocus on the primary mission as a Nation or profession”. This means challenging the “professional enabling system that supports this violation of free will, civil liberties, and human rights”. While sending an email to a congressperson may be the extent of modern citizen action, O’Brien argues that “morally, those who haven’t morally developed beyond the developmental obedience to unjust laws… AND are dependent on it, shouldn’t be the ones making the policies or law”. The pervasive dissociation and addiction within society mean this issue becomes the current generation’s problem, requiring citizens to “embrace the change and lean into the burn” to reclaim common sense power from the brink of “insanity”. As dependence is a state of addiction, addiction become the insanity when the dependence is ending.
In essence, the legal argument for citizen responsibility rests on the premise that the power ultimately resides with the people. When the systems they have empowered become “addicted” and “dissociated” from their moral obligations, it becomes the moral imperative of the citizenry to demand accountability and drive the necessary evolution towards a more just and morally grounded society. To Dr. O’Brien’s implicit point, psychedelics will do this for people whether the law likes it or not. If we want to prevent psychological and an actual civil war, then we have to heal from all wars, particularly the war on healing drugs and those who promoted their poisons over our natural plants, herbs, molds, and fungi.
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References
O’Brien, A. (2023a). Addiction as Trauma-Related Dissociation: A Phenomenological Investigation of the Addictive State. International University of Graduate Studies. (Dissertation). Retrieved at woundedhealersinstitute.org/courses/addiction-as-dissociation-model-course/
O’Brien, A. (2023b). Memory Reconsolidation in Psychedelics Therapy. In Path of the Wounded Healer: A Dissociative-Focused Phase Model for Normative and Pathological States of Consciousness: Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/courses/addiction-as-dissociation-model-course/
O’Brien, A. (2023c). Path of the Wounded Healer: A Dissociative-Focused Phase Model for Normative and Pathological States of Consciousness: Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
O’Brien, A. (2024a). Healer and Healing: The re-education of the healer and healing professions as an advocation. Re-educational and Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
O’Brien, A. (2024e). Path of the Wounded Healers for Thrivers: Perfectionism, Altruism, and Ambition Addictions; Re-education and training manual for Abusers, Activists, Batterers, Bullies, Enablers, Killers, Narcissists, Offenders, Parents, Perpetrators, and Warriors. Re-Education and Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
O’Brien, A. (2025). American Made Addiction Recovery: a healer’s journey through professional recovery. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
*This is for informational and educational purposes only. For medical advice or diagnosis, consult a professional.
