Thoughts from the PCSR Gathering
How heartening to be in a room full of people gathered together for the sole reason that we believe that psychotherapy and counselling should have a political and socially responsible edge. With the recent dispiriting trends in these psychological therapies, most recently expressed in the latest BACP consultation on its new ethical framework – part of a disturbing move towards accountability and outcome orientated practice – it is encouraging to know that one is not alone in swimming against the tide.
The PCSR event centred round four themes: political issues; ecopsychology; the therapy profession itself and underlying cultural trends. I chose to join the latter. The discussion was lively and sometimes impassioned, and at the half-way point where it became possible to change groups no one in this group wanted to move.
Over the past fifty years or so, the psychological therapies have exerted something of an influence on culture at large. We have seen changes in many fields of public and private life which reflect a growing awareness of the psychological impact of conditions and behavioural norms upon people. The education system has incorporated sensitivity to children’s emotional development as well as to their training in the basic skills of literacy, numeracy and citizenship. Public broadcasting and the mainstream press have removed the worst excesses of discriminatory language. Diversity awareness is enshrined in law. At the same time, our media have become more preoccupied with the personal and the psychological. We see behind the scenes of royalty and performers and are no longer content with a public face divorced from private angst and messiness. News stories centre on personal impact of events, giving fly on the wall accounts of ordinary people caught up in events. The cult of the celebrity raises the personal to ever more dizzying heights as foibles and silliness become the dominant idiom of mass entertainment.
Against this apparent trend towards a more expressive culture, however, other phenomena suggest that such offerings can really be seen as the product of a depersonalised commercialism. Emotional outbursts, tears and tantrums sell newspapers. With the growth of heart-on-sleeve revelations, the humanity presented to us on a daily basis becomes a caricature of itself, stripped of the subtleties of ambivalence and paradox which make up real human psychology. In particular, new forms of communication, with their reductive high speed immediacy, lead to more simplistic, knee-jerk responses and less considered, complex interactions. Even conversation becomes a packaged product when limited to 140 characters.
In the psychological professions, the move towards accountability, evidence-based practice and outcome orientated therapies is worrying not because we do not want to offer a something useful to our clients, or because we have bad-practice to hide, but because we need to be concerned about which outcomes are deemed important and whether they are measurable at all. If our intention is to encourage our clients into paid work and out of the unemployment figures, this is a measurable outcome. If our intention is to prevent clients using in-patient facilities, with all the costs involved, this also is a measurable outcome. If however, we see therapy as involving a more holistic process of self-discovery and growth, it become much harder to measure the results objectively. If we hope that our clients will become happier and more loving, this too is harder to quantify.
Of course even qualities which seem difficult to pin down have their measures. We have happiness and well-being scales, and the development of compassion, albeit largely self-orientated, is now offered as a therapy. Mindfulness is being taken out of its original context, losing its roots in spiritual practice and being taught by people with little training or experience of its background. Do such cross-overs of method enrich the culture of therapy or impoverish the culture religion and humanity?
There are hopeful signs. Around the edges of the therapy world, new growth in areas such as ecopsychology and some spiritually derived practices do seem to buck the trend to stream-lining and efficiency. At the same time, whilst diversity and good practice are enshrined in guidelines and frameworks, the danger is always that conformity to pressure of finance and the fear of litigation – bi-products of a consumer rights culture – subsume the idealism that they might have first represented.
The political edge of the therapeutic professions has a vital role to play in society. Just as psychological insight has reformed some of the more blatant discriminatory and abusive behaviours of the past, so too it can critique some of the current social trends. Whilst some of us may tend to drift towards the fringes for refuge from the onslaught of regulation and the possibility of government intervention in the profession, keeping a voice in the mainstream is important and may influence some of the decision making for the better.
This is a difficult position to hold however. Too often idealism creeps and morphs into pragmatism as we are subtly influenced by the arguments of the current social paradigm. Also, it can feel risky to dissent from ideas about things such as accountability (which I think none of us would see as a bad thing in itself) when a culture of whistle blowing and increased monitoring is developing around us. For this reason, gatherings such as the November one and collective sharing of ideals provide important anti-dotes to the isolation many of us feel when reading the epistles of our professional associations. Fears of the prevailing culture should not prevent us from trying to hold onto those values which first inspired us, often in decades past, or from drawing on them to re-inject energy into a system which sometimes seems to be losing the energy to hold onto its own ideals.
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