Psy-Complex in Question: Critical Review In Psychology, Psychoanalysis And Social Theory - Ian Parker 2018

Implausible Professions
On Psychology and Psychotherapy

House, R. and Totton, N. (eds.) (1997) Implausible Professions: Arguments for Pluralism and Autonomy in Psychotherapy and Counselling. Ross-on-Wye: PCCS.

This collection addresses issues at the heart of contemporary counselling and psychotherapy in a European context. House and Totton bring together professionals who are profoundly disturbed by the activities of colleagues who have ambitions to administer how we should help others in distress, and in particular enthusiasts for the drive for registration of therapeutic provision and training through bodies like the BAC and UKCP. The contributors are following in the tracks of Mowbray’s (1995) comprehensive attack on the recent bureaucratisation of therapy and his careful debunking of the argument that if UK therapists do not regulate themselves they will fall prey to European Community regulations which would be far worse. The spectre of Europe is thus raised to frighten counsellors and therapists, and in the process the variety of different therapeutic approaches across the continent is obscured.

While Mowbray (who is also a contributor to this book) succeeded in showing that the ’protection’ of clients in the UK registration process often amounted to little more than a protection racket for the professionals who had succeeded in jumping first into the relevant regulatory committees, House and Totton take the argument a good deal further. As they acknowledge in their introduction, to be ’against’ registration in its current form entails being ’for’ something else, and so the book had to include an elaboration of underlying assumptions about the nature of therapeutic work. This brings the reader to a series of profound reflections on counselling and psychotherapy as moral-political activities.

The first part of the book traces through the way professionalisation operates to inhibit and sabotage creativity, both for the therapist and client. The notion of ’transference’, for example, is shown (in a chapter by John Heron) to operate as a warrant for the infantilisation of the client and aggrandisement of the therapist. Richard House picks up the bureaucratisation of therapeutic work in a deft critique of ’audit-mindedness’ in a later chapter, and we thus get a sense of the psychic stakes of the registration process as something deeply anti-therapeutic. Both Heron and House follow through some of these ideas in later chapters.

Part two of the book ranges over issues of therapeutic ’expertise’ (a myth nicely dismantled by Katharine Mair) and the ’models’ some therapists are unwise enough to appeal to when they want to seem as if they could be experts (and the idea that there could be a ’core’ theoretical model to underpin this expertise is helpfully unravelled by Colin Feltham). The third part of the book explores some of the costs of ’professionalism’, and the chapters here range from personal accounts of the attempt to gain accreditation (for example, in the chapter by Sue Hatfield and Cal Cannon) to critical reflection on the whole enterprise of therapy (for example, in David Smail’s exasperated complaint about the separation between therapists with their ’comforting illusions’ and the real world).

A charge often made against the critics of registration is that they have nothing to put in its place, and we often hear insinuations that these kinds of people don’t really have the best wishes of the clients at heart. However, this book does not evade the question of accountability. Rather, the approach the contributors take is very different from those who seem to think that ’ethics’ can be added in through the regulation of training, or that accountability will magically appear in accrediting bodies that are accountable to nobody. A distinct version of therapeutic work is being appealed to here which puts ethics at its centre.

The fourth part of the book reviews some conceptual resources for the regulation of therapists, and here there are some interesting reflections by Andrew Samuels and Peter Lomas (both from within a broadly psychodynamic orientation). This is taken further in the fifth, final part of the book which includes some detailed suggestions for the practice of ’self-regulation’. There are more personal stories, and these are neatly complemented by an account (by Nick Totton) of the attempt by the Independent Practitioners Network to develop a new model of training, supervision and accountability.

There is an underlying agenda in this book, and this is where the ethical stance of the contributors is thrown into relief. Just as Mowbray’s (1995) book was addressed, as his subtitle acknowledged, to the ’human potential movement’, so ’pluralism and autonomy’ in the subtitle of this book signals a distinctive view of what therapy is about. A picture of the therapeutic enterprise emerges from the book which is rooted in a humanistic view of distress and change. The worst and best of this approach is present in the book. On the negative side, there are certainly some serious lapses into psychic reductionism, and some chapters assume the existence of unconscious ’projection’ and ’collusion’ which would make a psychoanalyst blush (for example in David Wasdell’s piece on the dynamics of accreditation). We are told many times in different chapters that the author feels that they have been true to themselves, as if that were sufficient for us to take their account on good coin. We do not hear the voices of clients who pay good money and sometimes exorbitant fees for the pleasure of being told what to do (or, in the most humanistic of therapies, being told to trust themselves).

However, on the positive side, the concern with openness about therapeutic stances and histories of training is a challenge to mystifying models of therapy which routinely legitimize deception and dissimulation. Humanistic approaches to therapy which revolve around the ability of clients to ’choose’ are followed through here in models of accountability which make that process of choosing something tangible, and a model for good practice.

House and Totton bring together many voices against the regulation of a kind of work that surely should have as one of its foundational aims the provision of a space for varieties of experience that escape the constraints of our administered world. The arguments collected here are invaluable for the development of that kind of work. Each disdainful dismissal of Mowbray’s arguments against registration and each avoidance of House and Totton’s pleas for pluralism is a symptom of the state of an increasingly bureaucratised ’profession’. A careful reading of this book would serve to open up questions about registration and help therapists and clients register their dissent and find some better ways forward.