Gary Tomkins BA Hons., Dip.
“What's in a name? that which we call a rose
By any other name would smell as sweet.”
William Shakespeare - Romeo and Juliet (1595) act 2, sc. 2, l. 43..
“Accreditation gags the mouth, dulls the brain and hardens the heart.”
Gerald Phillips - email communication.
Psychotherapy in the UK is in turmoil. Self-serving psychotherapists organised in several competing trade organisations (UKCP, BCP, BACP etc.) are seeking to ring-fence the field of psychotherapy in the name of protecting the public from supposed charlatan or abusive psychotherapists. They are trying to do this by getting the Government to legitimise their claim to the whole field of psychotherapy through the introduction of specific legislation. Entry into the field will be by attaining accredited and registered status and Government legislation will forcibly prevent anyone outside of their ring-fence from calling themselves a psychotherapist. Consequently psychotherapists are working in an atmosphere of uncertainty as their right to continue their livelihood hangs in the balance. Those who want to call themselves psychotherapists will therefore be required to undergo, or to have undergone, specific training courses and submit themselves to various examinations set by the regulating body. They will have to sign away their right to develop and live by their own values and ethics when working as a psychotherapist. Little evidence has been presented to back up the case for accreditation and registration and it is the purpose of this article to convey that to not recognise the fallacy of psychotherapy accreditation is to show a fundamental lack of understanding of the nature of psychotherapy. Whilst I recognise this may well be quite a challenging statement to many psychotherapists, I stand by it in order to prevent the title of psychotherapist from being annexed, corrupted, and diminished.
Before going on to explore the indefinable nature of soul and therefore psychotherapy itself. I want to highlight how the Government and the Psychotherapy Trade Associations attempt at legislation (a process that requires accurate definition) is actually incongruent with the ancient and modern definitions of the word psychotherapy. Later I will look briefly at the impact the drive to registration and accreditation by Government, Trade Associations and Training Organisations is having on those not often mentioned clients. Finally, I will outline some proposals for a more client centred and soul respecting approach to enhancing the delivery of psychotherapy to the public.
Looking at the roots of the word psychotherapist is a good indicator of the scale of the crime against soul the Government is likely to perpetrate. Splitting the name into its two constituent parts we find that “psyche” means soul (or spirit) and “therapist” means attendant. A “psychotherapist” is therefore someone who attends to soul. From this it becomes plain that the Government legislation is going to make it illegal to attend to soul without being accredited and registered. I do not limit soul to individual humans; the Ancient Greeks had the concept of the World’s soul, later referred to in Latin as Anima Mundi. To the Ancient Greeks, the modern environmentalists would be psychotherapists to the world and as such the Government could be in the process of making the picking up a piece of litter an illegal act. In this light the ludicrousness of the Government’s proposals becomes apparent and there is a need for the Government to clarify what it means by psychotherapy. The way things are heading, people such as Jesus Christ, Mother Theresa, Gandhi were they alive and the Dalai Lama, would all be liable to public prosecution for their actions (although they might be exempt if the Government legislation is limited to those who charge for their services). When simply listening, the psychotherapist’s primary tool becomes a criminal act; you and I are going to be liable to prosecution too. Leaning over the garden fence and hearing the vagaries of your neighbour’s life will soon be an act you have to be registered to do, never mind having had to have taken courses to learn how to do.
The New Oxford Dictionary definition of psychotherapy is “the treatment of mental disorder by psychological rather than medical means” highlighting another of the pitfalls behind the drive to accreditation. The Government is trying to include Psychotherapy within the field of Medicine when the modern definition states “rather than by medical means”. Ann Richardson, the Senior Policy Advisor to the Department of Health, has stated, “Psychotherapy is an activity, not a job title. It is important to say it would be extremely difficult to regulate by statute something, which is an activity like that”1. In other words, Psychotherapy is as much, if not more, an art than it is a science. Some stages or types of psychotherapy, such as Cognitive-Behavioural work might be suitable for objective measurement and therefore suitable for scientific assessment. To extend this to all areas and stages of psychotherapy though demonstrates a narrow understanding of psychotherapy, threatening to eradicate essential and life supporting forms of soul care, not on the basis of their efficacy but because their methods are not measurable. Scientific method relies upon the visibility of criteria and the yardstick used is one taken from the world of medicine, notably the presence or absence of symptoms. In psychotherapy troublesome physical symptoms are seen as an expression or communication of dis-ease between the soul and the body. With this different perspective, symptoms are not there to be eradicated or medicated out of existence but are messages to be listened to. A man starting to display symptoms of depression, such as crying, a need to be alone, lethargy etc. could in psychotherapy be seen to be improving if one takes into account that his wife had died suddenly a few months ago and the therapy has helped him out of shock and into grieving. Progress in psychotherapy might therefore be measured by an increase in the number or even intensity of symptoms. Similarly the attitude to dreams in the two fields is completely different. To the psychotherapist dreams are not just random brain activity sorting through the contents of the day but rich and accurate communications direct from the soul. Dreams and the images they bring are the language of the soul. Why then is the Government trying to apply criteria relevant to the field of medicine to the diametrically opposed but complementary field of psychotherapy? Does it not occur to them that a completely different approach is necessary?
The Undefinable Nature of Soul
My greatest objection to accreditation however is not what such attempts do to the ancient and modern definitions of psychotherapy but the ignorance that such an attitude displays about the very nature of soul. Heraclitus2 said “You would not find out the boundaries of the soul, even by travelling along every path; so deep a measure does it have”. Any attempt to define and limit soul is an offence against its very nature.
Anything that I do from here to describe soul will never do it justice. Soul is as poly-diverse as our dreams. I once got into an argument with my training group and supervisor over the act of naming. Naming, it was argued, gives you a handle on something and allows you to move it around. My argument was that the act of naming only gives an illusory power over things, the sense of being able to move them about. By way of illustration I suggested they screw a handle to the floor and try moving that. The particular example was to do with a piece of dream work in which the group had wanted me to give the name of Witch to a powerful female figure that had appeared. I had chosen to not to do this on a firm conviction that this would disempower her, turn her into something she was not, rather than respect her individual autonomy and unfolding importance. Whilst the figure demonstrated witchlike characteristics, to call her a witch, was to miss the particular individual qualities she in her individualness was bringing. The act of naming lops off the edges, blunts our perceptions to the reality of soul, so that our tiny egos can cope and make sense of the reality we live in.
Having pointed to the great risks involved in trying to describe soul I will risk the statement that soul is to do with individualness. What I mean by a person’s individualness is the uniqueness that manifests from an ongoing conscious, congruent and healthy relationship with their Self or essence. Jung named this particular kind of relationship that develops with the passage of time, individuation, and it is this that enables an individual to embody soul, to become ensouled. The passage of time or the acquisition of age seems essential to the embodiment or manifestation of soul in the world. Put another way, you are the only you in the world and there is no one or no organisation out there that can mirror you or tell you who you are. If this work, psychotherapy is about paying attention to soul then the one thing that it is essential that a psychotherapist mirrors or demonstrates to their clients is to be themselves. The therapist bound by an organisation’s fixed rather than fluid code of ethics, and in fear of being struck off a professional register is likely to spend more time looking over their shoulder in fear, than facing their client with an open heart. Their actions, approach and allegiance are more likely to be oriented towards placating criteria set by governing bodies than attending to and honouring their client’s individuality. Under such conditions the foundation of the work is some set of external criteria determined by an absent “power-over” authority. This dynamic cannot help but be repeated in the work, with the client being perpetually shackled in an unequal, inequitable and patronising relationship, little different from that of a parent to a child. Andrew Solomon expresses this well in his book “Blake’s Job” where he uses William Blake’s illustrations of the Book of Job to address the parallel issue of an individual’s relationship to God:
"Dependence means involuntarily attributing to other people, whether singly or collectively, something of the guiding authority which a child finds in his parents. In adult life this authority may be attributed to society collectively as the power behind conventional morality... It is dangerous to defy public opinion. Anyone who depends for his security on belonging in a social group wants that group to be strong and stable; and he is anxious to prove that he is an acceptable member of it, that he shares the opinions with which it is identified. But he feels insecure, he knows very well he is not quite what he pretends to be; so he is only too keen to demonstrate his disapproval of those who do not conform and yet he is jealous of their freedom, which he denies himself... The reality is that many separate individuals support the same prejudices so that they can borrow the collective power of the group. These common prejudices do change, but only slowly, because what counts is not what the individual genuinely thinks, but what he believes most other people in his group think."3
How will the client ever experience an equal, mature, independent and empowered relationship with their therapist when the source of authority lies outside the therapy room?
I call my work Individual Psychotherapy not simply just to describe my work as being with individuals rather than groups, but to make clear the particular emphasis on the individual nature of the work, This emphasis on individualness might seem selfish but I am sure that the kind of connection to oneself I have described requires a fundamental understanding and respect for one’s own otherness and this simultaneously brings about a recognition of, and respect for, other people’s individual uniqueness or otherness. In recognising our essential wholeness and that our own nature includes many dark forces, such as destructivity, it becomes essential to embody these forces if we are to become who we are. Consequently relationships formed between individuals who embody their wholeness, because they contain these dark forces, are essentially healthy but do not necessarily run smoothly. Relationships that externalise these dark forces tend towards a regressive merger that repress the individual and have little or no true awareness of other. Emphasis on the individual is therefore a homeopathic and paradoxical cure for selfishness bringing people into more challenging but wholesome and healthier relationships.
Often soul is seen as solely mysterious, elusive, unknown, located within ourselves but to me, soul is also in the world; animals, objects and places can all be said to possess soul. A chair for example can have soul, but it would not be just any chair it would be one with a history, one that demonstrates the ravages of time, that holds personal meaning to someone. A mass produced plastic chair straight out of the factory would best be described as soulless. When that chair acquires individual uniqueness, a history, for example where your son cut into it with the kitchen knife all those years ago, it gains soul. A hand crafted chair might well leave the workshop already invested with soul due to the attention it has had lavished upon it by the craftsman. In this way soul is in the attention to detail, the quality of workmanship, the care taken in it’s making, perhaps even in the sensitivity to the planets ecology when the construction materials were selected. These are the things that go to make its history, it’s story. If we look with a soulful eye we do not look to the perfection of the new but the value and meaning in the old that has taken on it’s own unique identity. The chair grows into what it was meant to be. James Hillman, founder of Archetypal Psychology describes in his book, the Soul’s code, how an individual’s soul comes into the world choosing the parents and surroundings essential for the individual’s personal development and cites many examples of how famous people’s apparently debilitating backgrounds turned out to be entirely appropriate proving grounds for their ultimate destiny. In this way we can see how our past actually shrinks us into our destiny or individuality. It is not surprising then that psychoanalysts are referred to as shrinks.
Individualness means distinct to the mass, a fundamental and irreducible uniqueness. How can anything that is so unique be measured? How can anyone’s suitability to honour such uniqueness, never mind the sheer variation in uniqueness between individuals, be judged? As Whan has described it
“What registration effectively does is to place a boundary of legalized control and definition around the notion of the psyche and those permitted to work with it. This works against a more ecologically sensitive psychology and psychotherapy.”4
What the Government and trade associations are looking for is certainty and authority in a realm where it has no right to sovereignty. By giving in to registration/accreditation psychotherapists collude with this illusion of power over life, duping the public into assurances of psychic security whilst simultaneously betraying psyche (soul). They consign psyche, the very foundation of their work and life itself, to the role of nothing more than a bit part in the drama of life. Such arrogance reeks of hubris and it is no wonder with such an attitude that as Jung put it “the Gods have become our diseases”5 and that there is so much work for psychotherapists. This arrogance and pretence of knowing destroys the mystery of life, turning life into little more than a pre-solved riddle. Whan speaks to this when he says
“No matter how perfect it makes its 'codes of practice and ethics', its 'theory' and 'practice', psychotherapy will be swallowed by its own power driven shadow.”6
Therapy under such circumstances takes on a standardised form with the therapist maintaining the illusion of knowing better than the client, all the time exploiting the client’s misplaced faith. The uninformed and naively trusting client meanwhile unknowingly suffers from a fundamental betrayal of their right to a soulful therapy, a therapy involving authentic meeting between two individual human beings. The client becomes the recipient of the therapist exercising power-over them, replicating the very parent-child dynamic the client is seeking to be freed from through an adult-adult meeting.
In recent years some training schools recognising the narrowness of specific therapies have moved to delivering a more Integrative training, looking to offer a more flexible and comprehensive therapy training. Whilst this is a move in the right direction towards meeting the individual needs of each client I think it stops short of meeting each client how he or she need to be met. The work I do, Individual Psychotherapy, avoids the pitfall of a standardised therapy by attempting to create with each client a unique therapy particular to him or her. As Jung put it “in dealing with individuals, only individual understanding will do”. 7 It is not for me to teach the client how to speak the language of a particular school (or schools) of psychotherapy but for me to enter their school and learn their particular language. This involves being open to their psychic world and communicating in a way that they can understand rather than dragging them into my world. The rich diversity of humanity that presents itself in my practice room is what keeps me interested and engaged in this work. The institutionalisation and standardisation of psychotherapy with its processes of accreditation and registration will only serve to standardise therapy effectively lobotomising the psyches of clients who try to avail themselves of these codified therapies.
I would like to start this section with a real life example of the damaging effect the drive to accreditation and registration is having on clients. Remember them, those largely anonymous ignored people who needed protecting from those supposedly wayward and harmful practitioners?
I supervise someone who works for a care organisation that provides support for family carers. To provide this support this charity organisation relies on both statutory funding and voluntary donations of time and money. With limited resources, the organisation has for some time employed student counsellors on a voluntary basis to help provide counselling support whilst providing them with a supervised context to apply their training. The students come from a variety of training organisations in the local area. This arrangement has generally been mutually beneficial to all four parties involved; the inexperienced students get the clients they need, with whom they can practice what they have learnt; the training organisation does not have to find or be responsible for practice clients for their students; the charity gets to fulfil its purpose; and the clients get access to free counselling. Cynically you could argue that there is a fifth party that benefits from this arrangement, the Government, who, via voluntary sector provision, are relieved from providing care they would otherwise be entirely responsible for.
Now throw into this scene the requirement for practitioner registration and witness the consequences. One of the training organisations, concerned about its membership status with the BACP, and in the face of new requirements laid down by the BACP, called a meeting of the care organisations its students are on placement with, in order to communicate these revised requirements. Two of these revised requirements were, that students were to be engaged in solely counselling work i.e. their work must not include elements of welfare advice/information provision and, that tape recorders would be used in sessions for accurate assessment of work. It is not so much the particular requirements that are the issue here, impractical and invasive as they are, but the direction of the power. The BACP imposes what it thinks is best on the training organisation, which in turn imposes something on their student counsellors, forcing the care organisations to change how they provide care to those who need it, the clients. It is all in the wrong direction. It is the clients’ needs that care organisations are recognising and seeking to meet, and it’s the training organisations, (who by the way do not own “their students”) who should be helping the students to more ably meet these needs. The trade associations, such as the BACP meanwhile could be more gainfully employed lobbying Government and business organisations for funding to better equip trainers for this radical new venture in client lead care. They, among other things, could also be promoting the benefits of counselling and psychotherapy to the public and informing them how to access it. Fortunately someone representing one of the care organisations did speak up at the meeting to point out how the training organisation’s presentation was paying little respect to their position or needs.
The pattern of power highlighted in the example above is a reflection of how society operates today, with Government remote, out of touch and disconnected from its electorate. In this context people are seen as servants to the Government, rather than the Government being there to serve the people. Under these conditions a psychotherapy that places emphasis on the individual can be seen to be anti-society. If society encourages normalcy and conformity how can social standards be applied to an activity, which encourages individuality, true independence and is effectively anti-social?
Whilst contemporary psychotherapeutic work might increasingly involve the normalisation of clients who present as lacking in sufficient ego identity or development, to restrict it to this area by Government legislation is to reduce the role of psychotherapist to little more than a State parent to its dysfunctional citizens. Those in our asylums and prisons fall into this category. Society has in effect, labelled or named, these people outsiders. Society, by placing these individuals beyond the bounds of society effectively scapegoats them, allowing those inside the bounds to project their dark side onto the outsiders, furnishing themselves with a false sense of self-righteousness. I am not advocating here a massive reform of our penal system however I do think we should not be blind to who it is that is making the rules that say who is “in” and who is “out”. If the Government sets the criteria for how therapists should relate to outsiders, we risk reinforcing our righteousness, losing the value of what we have shut out and remaining blind to our own wholeness.
This kind of work used to be the province of secular ministers who were invested with the authority of the church. With the failure of modern religion, psychotherapy has stepped in to fill this gap. If psychotherapy shackles itself to the authority of Government it risks being set up to fail the public in the same way religion has done. I include here a couple of email comments made by a colleague, John Freestone, which further illustrate the point.
“The main value of being fully independent from authoritative bodies is the same advantage a client has in talking things over with someone outside their normal social circle.”
“The real motives for handing authority to our 'club' have more to do with the therapist's own indoctrination in our authoritative society and, sadly, the competitive urge to be able to say 'BACP- accredited', or even just 'member' on our publicity material and “get those clients!””
Further down this food chain of power, Denis Postle in his incisive article “Lead into Gold” 8 explores the use of this “power-over” at the level of training schools and accrediting bodies/trade associations. He also sees these organisations as exercising power-over practitioners and demonstrates how this is having a detrimental effect on the diversity and development of therapies on offer to clients. This narrowing of choice of particular practitioners and the types of recognised therapy available, can also be seen as an attempt to elevate the status of those conforming practitioners further exaggerating the power-over differential in the therapist-client dyad. The implications of the therapist placing their authority in their training or accrediting organisation and the client in turn placing their authority in the therapist are again well expressed by Solomon, in his Book of Job,
“However well he may succeed outwardly in obeying a rational moral law, in doing so he is false to himself. This obedience to an external, quasi-parental authority is a way of clinging to a state of childish dependence, which is unworthy of a mature adult. It is a repudiation of his own personal authority, an abdication of personal responsibility, and makes itself felt as a failure in integrity and a sense of inferiority….. no man can ignore his natural feelings and impulses and force himself into an externally imposed mould of that kind without producing an inner conflict. What is suppressed will give rise to forbidden desires of a debased and compulsive nature, which are hard to control.”9
Or as Charles Waterman put it "You can't make men moral by act of parliament". Does the medical model backed by Government legislation, and so sought after by trade associations actually work? Did it work in the recent case of Dr. Shipman or the Bristol Royal Infirmary tragedy? Registration and accreditation do not suddenly miraculously transform people in to flawless practitioners and neither has it prevented abuse being prevalent in other occupations or professions. The complaints still happen. David Kalisch speaks to this
“Again it may be argued that under the current arrangements anybody can set up a name plate and call themselves a 'psychotherapist'. The reality is that very few do, and 'charlatans' appear in all walks of life not just the therapy field. In reality, in this as in other trades, people vote with their feet - if you set up as a 'builder' and have few building skills, people soon take their business elsewhere, and so it is in the therapy world. In this area of activity the market truly is the best regulator there is. In fact clients/patients are far more likely to be taken in and not trust their instincts by those few 'psychopathic' personalities with books to their names and certificates galore on their wall who haunt every sphere of activity where 'trust' and human relationships are involved. Needless to say, these types are always the first to accredit and 'look' respectable.”10
Even if you ignore the consequences on the therapeutic relationship of the false glow of external validation those practitioners who have achieved accreditation are enjoying, the present drive to accreditation still has cause to undermine this false sense of authority. These practitioners right to their livelihood is still under threat due to the uncertainty as to whether the Government will recognise the particular trade association/organisation that has accredited them. During recent negotiations about proposed registration the British Association for Counselling (BAC) representing some 20,000 counsellors (and psychotherapists) was not included in discussions with the Government. In what looks like an attempt to be included in this process the BAC has changed it’s name to the British Association for Counselling and Psychotherapy (BACP). Exclusion of an organisation will mean loss of perceived status and authority resulting in a decline in membership as members migrate to other recognised associations. In such an event the loss of members, and their membership fees, poses a serious threat to the existence of the organisation and the staffs employment. Executives with their employment and income on the line are likely to make decisions for their organisation based on what maintains or increases membership rather than what instigates good practice. With legislation approaching the scrabble to get members to jump through the hoops of accreditation can be seen with the BACP laying on accreditation workshops around the country to meet the demand they were partly responsible for creating in the first place. Ironically the Government’s own ring-fencing process could result in them being the ones shut outside the fence. They could become the outsiders! The more members any organisation has working to imposed standards the more chance they have of being recognised by the Government. Here is a quote from the 1990 UKSCP (the forerunner of UKCP) Chairman’s report that makes these vested interests explicit.
“What I think we now need, as much for self protection as for any other reason, is to put together a list of the members of our member organisations… This…. could be the basis of an accreditation process…. The further we are with our regulatory machinery, the harder it will be for the Government to ignore us…. No government will want to spend time on our problems, they would prefer, a neat and ready-made solution. If we have one, we should be irresistible. Better still if we have one before we are asked.”11
Training organisations, schools and colleges are not exempt from this pressure to be inside the ring fence being applied on them by the trade associations who bestow accredited status on their courses. I have recently heard an example of another charity organisation that provides training for counsellors being told by BACP that they will not be able to continue their work, as it does not conform to the required standards. The nation could be in for a big shock, as suddenly thousands of volunteer counsellors will not be permitted to continue their work. In a market over-supplied with training courses the need to attract students becomes a financial imperative if a particular training course is to survive. Potential students are likely to place high value on courses with accredited status, as these will make them eligible to practice if legislation is passed. The drive for registration here prises the locus of authority away from the prospective student denuding them of the autonomy to decide what they need for their development as a therapist. The very first step into training to be a therapist has within it an implicit handing over of personal authority to an external body. The student is immediately indoctrinated into the system of power-over that they later apply to their clients having been unconsciously trained in it themselves. The parent-child dynamic this sets up in training makes our therapy schools nothing more than re-runs of the family scenario. Whilst some schools have recognised this and use the experience as a learning opportunity for students the problem comes when they reach the developmental equivalent of leaving home, i.e. graduation, unaware of the developmental challenges that still remain in life. A student dependent on an external body to direct their learning is then cast adrift in the world with little idea of how to complete the other developmental stages of independent self-directed practice. No wonder the trade associations are concerned about all the therapists the training schools have let loose on the psycho-practice plain. Then what do they do but rope them back in for more of the same. More training, supervision and guidance from the know better authorities on how to develop their practice, all wrapped up in a neat package requiring regular renewal, with the threat of the withdrawal of accreditation for non-compliance hanging over the supplicant practitioner.
The issue of power-over is not the only trouble with trainings, they display an ignorance of the nature of soul in how they attempt to “train” people in some collective normalised way when a unique approach is required for each individual. Where is a therapist to learn the unique approach each client needs other than from each client? Indeed I question the current vogue for “experiential” psychotherapy trainings being carried out in groups, when psychotherapy is actually carried out in private between individuals. In fact Edwin Ervine in his book Philosophy and Psychotherapy goes as far as challenging whether training actually makes for more effective psychotherapy at all. Analysis of a collection of studies comparing the outcomes of work by professional counsellors and para-professionals shows “no evidence that professionals are more effective than para-professionals. They [Berman and Norton] go on to ask whether training make a therapist more effective, and conclude: “On the basis of current research evidence, we have to concede that the answer is no.””12 Maybe the reasons behind these surprising results are, as I outlined earlier; the ignorance as to the nature of soul, the exertion of power-over and simply not listening to the client.
So far in this article I have highlighted the fallacy of psychotherapy accreditation and the detrimental effect the drive to accreditation and registration is having not only on the practice of psychotherapy but most importantly on the souls of its end users, clients. The thread running through this article has been one of the damaging effect the established order of power-over has on clients as it runs down from Government level, through trade associations, training organisations to psychotherapists and finally onto the clients. (At times during the drafting of this article I have wondered whether the Phallocracy of Accreditation might have been a more apt title.) I know I have been entirely critical of the established order and whilst I am sure there are some benefits to be had from the existing structure, I believe it needs a fundamental revision not further reinforcement through legislation. What I advocate is a reversal of the direction of power in which the client’s soul is placed back at the centre of psychotherapeutic work and the work of psychotherapists, their training organisations and trade associations are in service of them.
RE-ENSOULLING PSYCHOTHERAPY AS AN ALTERNATIVE TO ACCREDITATION.
The attempt by Government and psychotherapeutic trade organisations to regulate and “professionalize” psychotherapy is ignorantly betraying psychotherapy’s nature and essence. I suspect that the people behind such moves do not understand what it is they are trying to regulate. By appropriating the word to their own ends, they are effectively marginalising psychotherapy, pushing true psychotherapy into the shadows. As WH Auden said, “When words lose their meaning I am sure physical violence takes over”. The drive to accreditation and registration is symptomatic of how far mainstream psychotherapy has strayed from its essence. The fact that psychotherapy effectively needs re-ensoulling demonstrates how far this process has gone. To reverse this tide of well-intended ignorance, positive steps are required to place soul back in its rightful place - at the centre of the work - ironic really given the actual meaning of the word psychotherapy – to attend to the soul.
I strongly advocate that the Government and the various trade organisations cease this drive towards regulation and accreditation. I believe this drive is based on a fear of human nature and the fantasy that everything can be made safe (and perhaps the desire to make psychotherapy a middle class activity). If fear and mistrust in human nature are enshrined in the work, then what chance does any process as subtle as Soul making stand? I am for the removal of structures that inhibit the manifestation of soul. These structures shrink-wrap soul, suffocating the very life force out of the work. Psychotherapists practicing in an environment where uncomfortable feelings are outlawed by rules supposedly designed to protect the client, but that in actuality serve to keep the therapist safe, are hardly going to be of much use to their clients. Removing the structures that do not serve soul will mean a radical venture into trusting human nature, rather than fearing it.
Care needs to be taken when re-ensoulling psychotherapy that any structures that are set up create more space for the client’s soul, not less. We need to stop dis-empowering and nannying clients by encumbering their therapists to the point of incapability with ever increasing regulation. To get round the conundrum of how to protect clients whilst not banishing soul from the work, it seems to me that there is only one-way ahead - the re-empowerment of the client.
I offer the following suggestions in the hope that they will help this process and consequently develop better psychotherapeutic practice. I am aware that as a psychotherapist I run the risk of entering into the same power-over, know-better dynamic. In the absence of any focalised client voice you will have to judge for yourself the value of these suggestions that also come from my experience as a client.
Central Government could initiate a public information campaign to educate the public as to the nature of psychotherapy, its benefits and limits, how to choose a therapist, how to recognise malpractice and what to do to gain redress and compensation if they experience it. Furthermore in the absence of any focalised client forum, perhaps with the exception of POPAN, the Government could provide resources to set up some kind of client representative organisation that could help with a true re-ensoulling of psychotherapy.
By promoting psychotherapy the Government could encourage its citizens to take more responsibility for their own mental, emotional and spiritual well being and live less stressed and more healthy, soulful lives.
In outlining the limits of psychotherapy the Government would help people to have realistic expectations of the work and what is expected of them in the work. This would help people to know what kinds of issues could be helped by psychotherapy and whether they have sufficient resources of time, money, and energy in order to be able to commit to the work.
Educating the public about psychotherapy would make them better informed as to the type of therapist they might need and the kind of questions they could ask of a prospective therapist. If the public knew that they should trust how they feel about a prospective therapist and not just rely on what the therapist says, or what the certificates on the wall supposedly say about them they would be more likely to choose a suitable therapist. The public could also do with knowing they are perfectly within their rights to decline a particular therapist without a particular reason, even when they go through a referral service.
Demystifying psychotherapy in these ways (as far as it can be demystified) would make clients more able to recognise abusive situations or malpractice, something that regulation or accreditation will never prevent. Putting this information in the hands of the client helps to empower and protect them from exploitation in an activity where the therapist is often seen as “the one who knows”.
The Government could also educate the public as to their rights if they want to make a complaint against their therapist. As things stand, it might be best for the Government to provide legal aid and/or litigation specialists to pursue such complaints through the courts. The present situation where clients complain to trade organisations is inevitably weighted towards the protection of their members. There are few, if any, mechanisms in place for any kind of compensation to the client. Their most commonly applied sanction is to stipulate that the offending member undergo further training or supervision, a punishment that amounts to little more than a slap on the wrist for the therapist and, in terms of any kind of compensation, a slap in the face for the client. Such complaints often result in the re-traumatising of the client as they are re-exposed to the alleged abuser and the initial trauma… all this occurring under the auspices of people who are supposedly skilled in handling emotionally charged situations. The courts are the most likely place that the client stands a chance of receiving a fair hearing and any kind of recompense. My advice to anyone seeking redress with a recalcitrant practitioner is to go direct to court. There are many laws covering human rights that cover the kind of malpractice one might accuse a practitioner of. A simple change in existing law would empower the court to include in its penalty the possibility of prohibiting the offending practitioner from using the title of Psychotherapist to describe them or their work. In the future the Government could establish a specialised court, tribunal or ombudsman for dealing with such situations, which would combine the legal power of the law with a more comprehensive understanding of psychotherapy. A specialised court or ombudsman could be responsible for holding a record of therapists who have had claims brought against them and the outcome of such actions. This record could be made available to the public, bringing the kind of transparency Government is apparently seeking to bring to complaints procedures.
Trade Associations will need to make a fundamental shift in their attitude if they wish to be part of re-ensoulling psychotherapy. They seem to have ring-fenced for themselves an area of the psychotherapeutic plain, by setting criteria and charging fees to those therapists who want to be within their auspices. Therapists in effect pay not only to maintain their stake in something that was already theirs but also to increase their stake because “their” organisation shuts out/disenfranchises those who do not pay. The organisation publicises and promotes its supposed legitimacy, puffing itself up into some kind of trustworthy body that the less informed public naively ascribes authority to. This sounds very similar to the bullying way the trade associations in the early stages of the industrial revolution set themselves up, using their size to capture the market and supplant the long standing tradition of master and apprentice. The motives of these organisations seem to be self-serving, trading on people’s fears of exclusion, of not being able to attract clients and the consequent loss of income and livelihood. If only the BACP (British Association for Counselling and Psychotherapy) honoured its charity mandate and became an Association for Counselling and Psychotherapy, not for Counsellors and Psychotherapists, then things just might be a lot healthier.
The Independent Practitioner’s Network, with its peer accreditation system, has gone some way to reversing this top down power-over structure that the trade Associations display. Their peer accreditation system however stops short of a client centred model as it simply replaces the requirement for the client to give up their sovereignty to some distant anonymous rubber-stamping authority with the requirement that they give it up to their therapist’s peers and colleagues. The same problem as with other trade organisations remains - at the outset the client is encouraged to not trust their own experience. How a therapy underpinned by such legitimisation can ever hope to succeed is beyond me. Likewise how any complaints under such a system can claim to be free of the vested interests of the accused therapist’s colleagues continues to confound me.
What the trade associations could do is use their size and organisational structures to promote psychotherapy and counselling to the public, and inform them how to access it.
They could work to increase the profile of psychotherapy within the field of medicine by educating Doctors, Psychologists, Psychiatrists and related practitioners as to its efficacy when used to treat various disorders. The trade organisations are also best placed to set up research projects to investigate these claims. Personally, I would particularly like to see them actively challenge the short-term perspective taken by modern drug therapy that seems to lead to long-term dependence, lower quality of life and a tendency for patients to be using services through a revolving door. Statistics in the NHS take a short-term view, using short-term symptom relief as their yardstick rather than ongoing health. We have a National Ill Service not a National Health Service, where cure is the removal of a patient’s symptom and not the long-term well being of their soul.
The trade associations could, in partnership with training organisations, as I mentioned earlier, lobby the Government and business for funds to help train and re-train therapists in a more client led psychotherapeutic approach. The trade associations could use modern communication technology, i.e. the internet, to go beyond their
rather one way, top down, power existing form of printed journals with selected articles and edited letters. They could give up their “know better” patronising attitude and recognise the wealth of resources they have in their members and encourage them to develop networks of communication and information distribution amongst themselves.
In order to align themselves with a more client-led psychotherapy most, but not all, training organisations will need to reorient themselves to a more individual approach. When friends ask me about how to become a psychotherapist I suggest they find themselves an experienced therapist and enter therapy for some time, maybe a year or two, whilst dropping any aspirations to becoming a therapist. At present, being in personal therapy is increasingly becoming a requirement of most trainings. Whilst wanting to be a therapist is certainly reason enough for entering personal therapy, I think it is important to distinguish between the experience of going to therapy voluntarily, as part of a training, with that of a client who is generally driven to it reluctantly. If, after some time and having come to terms with their personal psychodynamics, the prospective therapist still feels sure about wanting to be a psychotherapist, they could ask their therapist to help prepare them for this. Their therapist could then highlight areas of learning or experience they might need to focus on, and in due course support them when they start to work with clients. Attending a basic counselling course to learn basic communication and listening skills would probably be advisable for all prospective therapists. I do not see it necessary for prospective therapists to attend three-years of training to learn how to listen. Such trainings tend to fill the trainee therapists beginners mind with various models, theories and techniques that do little more than inhibit their ability to listen and respect the individual uniqueness of the client in front of them.
Applying what I would advise a friend to do, to training schools, would mean the training schools allowing trainees to be more self-directive in their learning. People wanting to become psychotherapists will come with a variety of skills and abilities as well as aspirations. In order to honour this, and their trainees’ individual uniqueness, an individual approach is needed. For this reason, there is a need to return to the old style of training analysis, much akin to the master and apprentice relationship. This particular kind of relationship allows for the individual attention and intimacy necessary for an individual and soulful relationship to develop, one to one is after all the form the work they do will eventually take, not the high intensity morass of emotions generated by modern trainings conducted in groups.
Training organisations would have to relinquish the authority they assume over trainees. By making the trainee the centre of the work it ensures a strong demonstration as to the sovereignty/authority of the client in the therapeutic relationship. This would remove the unnatural objective pass/fail criteria that have been transferred from academia into today’s training courses where trainees are expected to meet both objective and subjective criteria set by trainers in the role of assessors. This sets up all kinds of performance anxieties and distorted behaviour in trainees as they try to show enough vulnerability and stability to make them effective therapists… ironically referred to by a colleague as “crying enough but not too much”. The removal of the pressure to perform would lead to a far more honest, open and trusting environment for learning. Group Supervision under an assessing supervisor as happens in present day courses trains the therapist in how to conceal their biggest blunders and potential learning experiences thereby depriving them of the effective supervision they need and the client of an effective therapy.
Under such a scheme training schools would need to be more open and flexible to the flow of trainees from one training school to another as the trainees seek to learn what they believe they need. Training organisations could provide basic counselling skills training as well as comprehensive lecture series to cover psychotherapy theory as well as more specialist or esoteric lectures. All these lectures could be open to trainees and experienced practitioners alike, who would be able to choose what meets their needs in an a-la-carte fashion rather than having to swallow the whole of a rather narrow menu. Unfortunately it seems that Gestalt South-West who had been operating such a system are having to move to a more directive authoritarian system in the face of accreditation requirements from Trade Associations.
The whole outcome of these changes that honour the trainees own authority and autonomy would be the transmission of a profound lesson as to the sovereignty of their client’s own process/psyche/soul. This recognition of the client’s sovereignty must be the fundamental underpinning of any ensoulled training course.
So finally what could therapists do to re-ensoul psychotherapy?
Individual supervision is essential to good practice. Individual supervision as opposed to group supervision allows for the kind of intimacy in which the therapist can bare their most vulnerable selves and client confidentiality is best protected. Group supervision can be useful in addition to individual supervision. In-group supervision particular issues or themes can be looked at, as can any difficulties that arise for a supervisee in their individual supervision. However skilled, experienced or aware a therapist is, to assume one is free from unconscious influences is an act of extreme hubris and shows a gross ignorance as to the workings of the psyche. To believe that one has sorted out one’s own unconscious material to the point where one is not likely to get caught in the unconscious dynamics of the therapeutic relationship means taking a position of certitude and closes the therapist off to the individualness of their client. In fact some of the most profound work in psychotherapy comes from the effective use of the unconscious dynamics generated by the client towards the therapist and the therapist towards the client, known technically as transference and counter-transference respectively. I believe there is a widespread mis-understanding as to the use of counter-transference, where therapists are deluding themselves into believing that they can spot their own unconscious dynamics in relation to the client. The reality is however that this awareness only comes to light later. Effective supervision can hasten this process and will minimise, but never eradicate, the potential risk of harm that may come to the client.
Another step towards re-ensoulling the practice of psychotherapy from within is a change of attitude by therapists. The kind of shift required is that of seeing themselves not as a profession but as service workers, as being poly-employed, not self-employed. Their clients, who have the right to hire and fire them, are in fact the therapist’s employers. The word profession has it’s roots in the claim of being skilled in a certain occupation and therefore tends to lead the public into believing they can hand over responsibility to the therapist. Therapists can never do the work for clients and to encourage such an abnegation of responsibility goes against the very core of effective work. Psychotherapy is not like mainstream medicine, it is not a miracle pill to be swallowed that magically cures the client but something the client has to actively engage in. The therapist cannot do the work for the client. just as they cannot live the client’s life for them. Psychotherapists can only work with the client, assisting and supporting them as they change themselves and their lives. Clients are the ones with the power to hire and fire, and it is the therapist’s duty not to divest their clients of their sovereignty and autonomy. Therapists are there to empower, not disempower their clients, especially by not assuming, “professing” or insisting they are a better authority for the client than they are for themselves.
As the therapist’s employer, a client has the right to interview the therapist, who should respect this right, being honest and open about their training, experience and realistic about the chance of the client achieving the successful outcome to the work they are seeking. The client surely has a right to know a few basic things about the stranger they are about to bare their soul to. Therapists, who avoid such questions and imply it is the client’s insecurity that makes them ask, only demonstrate their own lack of empathic ability and an insensitivity to the vulnerability of the client. If a client did not have these feelings of insecurity and vulnerability, they would probably not be suitable for psychotherapy!
The removal of the threat of registration and accreditation, the weapons of fear employed by Government and Trade Associations, will improve the work of those who experience fear in the face of them. Those who invest their authority in governing bodies are likely to benefit from the challenge of owning their authority and bringing it into the practice room where their clients might then be able to avail themselves of the services of a whole human being. Therapists need to take up the challenge of being more responsible for their own work and development. This may well not involve additional formal training, more supervision etc. but by them living a more soulful life themselves. If the therapist is living a soulful life, a life full of soul, then the client coming into the psychic orbit of such an individual, is bound to be effected for the better. This is and must be, the ultimate challenge for a therapist, to improve their practice by living their life more soulfully. No legislation, no codes of conduct or list of ethics can prescribe how they should do this. The challenge is an entirely individual one, requiring the therapist to live, embody and demonstrate what they are trying to affect in their clients. It is not just about how they conduct themselves in their work but in all areas of their life. A decent therapist is not someone who has written many books on psychotherapy, headed professional organisations or trained on the most exclusive courses… a decent therapist is someone who lives a soulful life and can help others to live their life in accord with their own soul.
The last part of this article was written after a meeting I attended between Anne Richardson (Senior Policy advisor to the Government for the Department of Health) and IPN on October 13th 2001. The talk helped clarify the Government’s position on Registration that seems to have been blurred by the spread of self-serving mis-information by Trade Organisations and perhaps by the Government itself saying different things in different places. For a full transcript of the talk (but not the Questions and Answers afterwards unfortunately) see article -
“Statutory regulation of psychotherapy psychology and counselling: The Way Forward”
talk given by Anne Richardson to IPN London Gathering October 13th 2001 on http://ipnosis.postle.net/
1. Anne Richardson – Psychotherapy registration – a view from the Department of Health.
2. Heraclitus of Ephesus – Soul an Archaeology – Edited by Phil Cousineau
3. Andrew Solomon - Blake’s Job – published by Palamabron press.
4. Michael Whan – Registering psychotherapy as institutional neurosis: or, compounding the estrangement between soul and world – on http:/ipnosis/postle.net/
5. Carl Jung – Collected Works 13 – Alchemical Studies
6. Michael Whan (ibid)
7 Carl Jung – Memories, Dreams and Reflections.
8. Denis Postle – Lead into Gold - on http:/ipnosis/postle.net/
9. Andrew Solomon (ibid)
10. David Kalisch – Statutory Regulation - on http:/ipnosis/postle.net/
11. Quoted in Sonu Shamdasani – The Compulsion of Self Control – In Mindfield – Therapy on the Couch ed. Susan Greenberg
12. Edwin Ervine - The Philosophy of Psychotherapy