When I recently gave a talk on
“The limitations and dangers of counselling and psychotherapy
and their potential”, I did some research on the image of our
professions in the media, trying to establish what really the essence
of recent criticisms is, and what underlying stereotypes they are
based on 1 .
Whenever there is (meta-level)
discussion about the dangers and possibilities of therapy, it is useful
to remember that we are all liable to project our most pressing conflicts,
our most cherished preoccupations into our very idea of therapy. That’s
why the many public misconceptions, prejudices and fallacies about
counselling and psychotherapy do not appear to be amenable to change
through information - it’s collective transference. I would think
that any therapist worth their salt will read the client’s assumptions
and ideas about therapy as a possible projection, and will use this
as an avenue into what needs healing in the first place. It is precisely
this recognition - that each client will ‘construct’ the
therapeutic space according to the influential forces and constraints
at work in the client’s psyche - which tells us in the countertransference
what issues the client is most unconscious of (which are probably
the same issues which are most in need of being addressed) 2
.
And the same is true for training:
like the ‘primitive’ tribe to the ethnologist, the split
and fragmented field of therapy with its multitude of approaches offers
itself as a wonderful projection screen for our unconscious, particularly
our unconscious family drama. We can have our primary scenario enacted
in all its splendour between biodynamic mummy and analytic daddy,
or ‘good breast’ Alice Miller and ‘bad breast’
Melanie Klein, or empowering egalitarian humanism and patriarchal
medical power-trips, etc - please continue according to your own agonising
archetypal soap opera. It is one of the crucial issues for all counselling
and therapy training that students have the opportunity to discover
during the training just what aspects of their inner world go into
creating their individual preconceptions and images of what a therapist
is, does or should be 3
.
And it is one of the potentially
exciting aspects of our profession that this process never stops.
Having over the years experienced several major re-workings of my
own assumptions as to what ‘being therapeutic’ really means,
I am now more cautious about my current perspective and am not assuming
I’ve arrived at a final destination. And if I don’t exempt
myself from this criterion, I don’t see why I should exempt journalists
and psychiatrists: so what can we glean from their writing as to their
projections into us ? The main misunderstanding which runs right across
journalists and medical ‘experts’ is that they apply to
us the same paradigm which they operate by: the ‘medical model’.
And, of course, in terms of the requirements of that model they see
us failing left, right and centre. “She was labouring under the
common misconception that a counsellor’s job is to counsel [i.e.
to advise, direct, recommend ... ].” “There is no coherent
theory, and no evidence that it works.” “Full-time counsellors
will say they do it because they are interested in people - certainly
one rarely feels that they are engaged in a demanding intellectual
pursuit.” In the media the field of counselling and psychotherapy
is not judged on its own terms.
This week’s quiz: see whether
you can detect the two unfortunate yet revealing typos in psychiatrist
Dr Raj Persaud’s article in Counselling News “The Wisest
Counsel ?”: “Distinguishing whether one is alleviating suffering
or enhancing unhappiness is undoubtedly difficult ..., whether one’s
actions are returning a human being to a notion of a ‘par state’
or taking him or her from a ‘par state’ and helping them
to go beyond.” “The notion of a ‘par state’ is
important because it reminds us that suffering is perhaps an eradicable
part of human life; in a deeper sense it is part of the defining characteristic
of life.”
Typically, there is a split between
... - on the one hand seeing the therapist as all-powerful, omniscient
and omnipotent, being able to see through people and exploit their
dependency to the point of turning them into clones (e.g. the implication
that Susie Orbach used therapy to instill her feminist beliefs in
Princess Di and manipulated her into taking a certain political position
as demonstrated in the famous Panorama interview), and ... - on the
other hand dismissing the therapist as gullible, plain stupid or lacking
in intellectual capacity, woolly, whacky and esoteric and heaping
contempt on the whole enterprise as unscientific, unreliable and no
better than having a chat with a friend over a pint or a cup of coffee.
It is easy to see in the abstract that what we are talking about here
is the shadow side of the medical model, the other side of the benign,
benevolent and authoritative father figure which the medical model
is built on. This shadow aspect gets projected onto therapy, which
means that therapy gets treated as the culturally undervalued mother
(“you know, the one that does all that yucky feeling stuff”).
Isn’t the particular quality of this double-whammy accusation
(all-powerful manipulative versus stupid, irrational and spineless)
reminiscent of everybody’s favourite attack on ‘mother’
- maintaining a dismissive independence against the pull of a deeper
attachment and need ?
Emmy van Deurzen-Smith has recently
pointed out how counselling and psychotherapy have taken over professionally
the kind of tasks and skills which traditionally belonged to the role
of mothering. She hopes that what once was a craft and an art depending
on intuition can now - through the process of professionalisation
- be turned into an accountable science: the science of effective
mothering! The scientific justification is necessary because: “in
all this there is a real risk: that the soft end of the spectrum of
motherhood might overwhelm society in a counter-productive backlash
that could lead to matronisation and unarticulated, uncontrolled emotional
matriarchal domination . ... Many people who oppose our profession
fear just such a backlash of soft and oozing self-indulgence and psychological
pampering and they will keep fighting against the rise of psychotherapy
until we can show what our profession can provide that is constructive
and essential for a new world.”
I agree with Emmy that we can’t
help but be seen and treated as the spearhead of re-matriarchalisation,
but that’s precisely why I don’t want to accept ‘mothering’
as a self-definition of my essential task as a therapist. I think
therapy has a lot more potential as a discipline when we see it not
as representing one polarity in the cosmic battle of the sexes, but
- if anything - as facilitators of the war, both externally and internally,
helping to embrace the pain of the split between masculine and feminine.
So collectively we are - and certainly are seen to be - embroiled
in a struggle for validation with the medical model, which is the
modern offspring of the Newtonian paradigm. We are confronted with
it by our clients (e.g. the favourite question:“And how long
will it take ?” i.e. to change my whole being upside down and
inside out, including character structure and chronic symptoms carefully
built up over decades, against my resistance). And now we are confronted
with it by the media. In some way that’s fair enough: it pushes
us to clarify our position as psychotherapists in relation to the
medical model which is what I would like to do in the next issue of
the newsletter.
In the last newsletter I started
writing about the image of our profession in the media. What has been
bugging me for a while now is not just the frequently quite hostile
and dismissive attitude, but also the complete lack of comprehension
for the therapeutic process. But what has been bugging me even more
are the responses in our defence which seem to me to stop far short
of a convincing and grounded position which embraces therapeutic depth
and social awareness. My thinking got a lot more focussed when I read
the article by Emmy van Deurzen-Smith which I quoted last time where
she suggests the equation psychotherapy = professional mothering as
a basis for our future development. What really got to me was her
suggestion that we need to back this up scientifically in order to
make ourselves accountable. It seemed so apparent to me that this
would be re-enacting a basic split between ‘feminine mothering’
and ‘masculine science’, with mother’s right to exist
depending on a seal of approval from father. Isn’t it precisely
this kind of conflict which a lot of the time we are trying to address
in therapy? In my view, the whole idea that we should need to validate
what we do scientifically arises because we have come to take it for
granted that mothering is invalidated in our culture. Feminists
have made it quite explicit over the last 30 years that our culture
has a split and ambiguous relationship to mothering: both a controlling
idealisation (how mothers should be) and a contemptuous, and essentially
hateful, dismissal (when the mother-object fails that impossible expectation).
I think it is dangerous for us
as counsellors and psychotherapists to be seen as identified either
with the medical model (archetypal fathering as we know it) or with
the collectively undervalued nurturing role (archetypal mothering
as we know it). To me it seems obvious that we get identified
with both, and that the conflict between the two is a necessary aspect
of being a therapist. In my teaching and my practice I think I have
found ways of working with this polarisation: in the Charge group
one of the ideas we have been using for a couple of years now is a
spectrum of therapeutic stances between colluding and objectifying
(in simplistic terms: between being a ‘friend’ and being
a ‘doctor’). I assume that colluding and objectifying (“I
go along with everything you say” versus “You are a case,
and in my role I will apply whatever theory and technique will make
you better”) are extreme expressions of the two necessary
processes of identifying and differentiating (“I empathise”
- “I feel different”), i.e colluding is an extreme form
of identifying, and objectification is an extreme form of being differentiated
4.
As a therapist I pay a lot of attention
to those moments when I move from identifying into colluding, or from
differentiating into objectifying, i.e. when I slide from a therapeutically
necessary stance into - what feels like - a counter-therapeutic one.
Either way there is a sense that I am losing my therapeutic position,
the working alliance begins to feel threatened and I feel compelled
by some unconscious dynamic. That’s why paradoxically I think
of that move, that particular change of contact, that uncomfortable
and conflicted sense of losing the therapeutic position as a necessary
opportunity. There is potential in that moment both for a presumably
painful re-enactment and for an opening into deeper contact and transformation.
Going into the session I offer some equilibrium between identifying
and differentiating, knowing that I may well get drawn by the relationship
process into colluding or objectifying. As a therapist I have learnt
to embrace these as part of the process: sometimes I merge and collude,
other times I distance and objectify, and usually one extreme catapults
me into the other. Although I may not like these extremes I know that
there are treasures to be found there, that the unconscious process
is that falling into and swinging between these extremes.
But when I read about these same
polarities in the public arena, I strongly react against them, like
in Emmy’s article. I baulk at the suggestion that a collusive,
undifferentiated and indulging feminine stereotype (i.e. therapy)
needs to account for herself in relation to an objectifying, unrelated
and superior masculine (i.e. the scientific medical model). The difference
is that in therapy I embrace colluding or objectifying as part
of the process, but I do react against anybody defining colluding
or objectifying as the process. I think that reducing therapy
to an endulging mother backed up by an objectifying father kills it.
When I put it like that it becomes obvious that while I can find reasons
to justify my reaction, it also has a lot of my story in it. If you
read the first part of this article you will have noticed that I felt
angry, mainly in relation to the medical expert Dr Persaud. I felt
put down and nonchalantly dismissed, and I wanted to humiliate him
back (and I think I gave it a fair shot last time). In a way it is
through writing this that I am now trying to contain both my transference
and my countertransference to him (depending on which way you look
at it). Clearly he stirred up feelings about my father, which then
got more focussed because I also can’t go along with my mother
(Emmy) any more. Merging with the undervalued mother and making an
omnipotent virtue out of it, does not work for me any more, either,
but that is clearly an important aspect of what attracted me to becoming
a therapist. That’s why it is so important for me to write this
- especially if we are talking about the future of the profession,
which I am beginning to own as my profession - to establish
and to validate my position between the two polarities because although
I am aware of them, they’re clearly a long way from being integrated
in me.5
It is with these particular sensitivities
of my own story that I look at the collective and make sense of it
in deeper, archetypal terms. Having touched on my transference to
Dr Persaud and Emmy, let’s look at my countertransference. The
newspaper and magazine articles I studied suggest that on the whole
we are being seen more in the mothering role, with all the idealisations
and the contempt which this evokes. Public reaction to our profession
in the media has therefore a lot to do with the usually unconscious
relationship to ‘Mother’ which a journalist or ‘expert’
projects into us. No amount of information or argument is going to
be convincing to them unless it is embedded in a probably surreptitiously
‘therapeutic’ interaction which transforms that relationship
to ‘Mother’. Most articles I perused seemed to be written
by journalists who conveyed to me some longing for therapeutic attention,
but - by writing about therapy in the way they did - ended up creating
a particularly bad imaginary therapist which they then argued with.
In the ensuing dialogue this imaginary therapist kept systematically
missing the point and the pain which was trying to find a voice. This
is like a session with a client who is so caught in their mother projection
onto the therapist that everything you say or do gets filtered through
the complex.
We could dismiss these kinds of
articles as individual examples of misguided, and occasionally nasty
journalism. I’d rather read them as an expression of misconceptions
about our profession which are ubiquitous in the public at large.
Following on from above you will not be surprised to hear my view
that the essence of these misconceptions lies in the fact that the
‘therapy mother’ gets measured by the rules of ‘father
medicine’. We are expected to fulfil the requirements of the
medical model, but without being given the same taken-for-granted
authority. We are expected to provide for the whole human being, including
mental and emotional aspects, the same apparently predictable procedure
which medical practitioners are seen to provide for the body. It has
often been observed that when patients need the illusion that science
and medicine have got it all ‘under control’, doctors are
treated as ‘gods in white coats’. The hope and expectation
that there must be somebody out there who can command the mysteries
of life and death implicitly confers god-like status onto the practitioner.
The equivalent expectation in therapy amounts to a demand for a guarantee
against any kind of emotional-mental pain and distress - instant soothing
on tap. It can therefore be argued that the demand for a medical cure
administered by such a powerful therapist (which is what clients often
think they are paying for) is rooted in an infantile need for symbiotically
attuned quasi-magical omnipotent mothering, and is both an
expression of that need and a defence against it 6
.
If therapy does not fulfil that
implicit need, if the soothing isn’t forthcoming, if the ideal
mother can’t be omnipotently controlled, then the rage comes
to the fore, masked as a dismissal of the whole painful realm of feeling
and relating in general and dependency on mothering in particular.
The negative newspaper articles seemed full of this kind of distancing
disappointment: if therapists have the power to exploit the vulnerable,
somewhere the assumption is that through ignorance or malice they
usually will. The conclusion is: if therapy as mother will exploit
and let you down and betray you anyway, it’s best to make do
without it / her. The possibility of deep nurturing and any deep contact
then gets dismissed as dangerous illusion 7
.
The difference between therapy
and medicine in the public imagination lies in the different archtypal
images which are collective projected into the two professions. Although
there is suspicion and doubt surrounding the power of the medical
profession, in the end nobody wants to do without it (because we can’t
afford to be without the ‘omniscient father’), but therapy
is considered a luxury 8.
The body machine needs to be kept
in tact, but the realm of psyche and emotion, so dangerously close
to the ‘undervalued mother’, is so elusive and ‘unreal’
to people that they can quite happily - they think - do without. This
is what I understand Winnicott to address when he wrote 9
:
“Is not this contribution
of the devoted mother unrecognised precisely because it is so immense
? ... Many students of social history have thought that fear of WOMAN
is a powerful cause of the seemingly illogical behaviour of human
beings in groups, but this fear is seldom traced to its root. Traced
to its root in the history of each individual, this fear of WOMAN
turns out to be a fear of recognising the fact of dependence.”
In the next issue I want to focus
more on what I see as the underlying historical, archetypal dynamic,
and then draw some conclusions for our practice.
Draft
bits not published:
If
medicine gets associated with the dominant father, and therapy with
the irrational and gullible mother, the relationship between these
two paradigms is no different from the underlying patriarchal dynamic
between masculine and feminine which our whole culture is torn apart
by than that of many fraught marriages between men and women: in the
microcosm of the family as well as in the macrocosm of modern Western
civilisation the full potential of both polarities in this
archetypal battle of the sexes is lost in the interaction. Although,
of course, it may appear in numerous and various guises, this undervaluing
of the feminine can be seen to occur on all levels: intrapsychic and
emotional or interpersonal and familial or social, political and cultural.
Essentially, we are talking about the same relationship between an
objectifying, unrelated and superior masculine and a colluding, undifferentiated
and indulging feminine stereotype. It is mainly through Jungian thought
and feminism that we can think about this relationship in historical
and sociological as well as psychological terms10
.
In
these terms it could be said that many people come to therapy precisely
because they are suffering from such an internal split and conflict
between the patriarchal expression of a male archetype (for example
Zeus, Hercules or Apollo) and the corresponding female version (for
example Hera, Echo - the nymph spurned by Narcissus - or Iphigenia11).
Joseph
Campbell already wrote in 194812
: “for the findings both of anthropology and of archaeology now
attest not only to a contrast between the mythic and social systems
of the goddess and the later gods, but also to the fact that in our
own European culture that of the gods overlies and occludes that of
the goddess - which is nevertheless effective as a counterplayer,
so to say, in the unconscious of the civilisation as a whole.”
In
the wider historical scheme of things, it seems to me therapy becomes
identified as this ‘counterplayer’ which is why Emmy refers
to the dangers of ‘re-matriarchalisation’ as a feature of
therapy which people will resist. But we can’t clear up this
fear through information. As I said in the first part, it is usually
only through the experience of the therapeutic process that people
discover which aspects of their psyche - individual and collective
- they project into therapy in the first place. So if we can’t
stop society projecting onto us their ambivalence in relation to ‘Mother’
and dismiss us in relation to the superior ‘doctor-father’,
the best thing we can do is get clear in ourselves. If we don’t
take the projection on board as a self-definition that our role is
indeed ‘mothering’, we will not be so surprised when people
are reacting resentfully and are disappointed before we’ve done
anything. Rather than conceiving of the therapist’s position
as resting in a mainly motherly presence, I think it’s more accurate
to say that in practice we get caught between the ‘nurturing’
and the ‘medical’ paradigms like millstones. Therapy can’t
help but operate in the tensions between treatment and (intersubjective)
relationship (subject-object versus subject-subject).
Whenever
we try to resolve this conflict towards one side or the other, we
actually - in my opinion - have not got a therapeutic position any
more. However, as therapists we are forever in danger of taking habitual
stances which try to do just that. Many humanistic therapists, for
example, eschew the ‘medical model’ or positively fight
against it13, but, amongst
other things, it could be argued that in doing so they then impose
an egalitarian ideology on the client’s actual internal reality.
The client does not feel equal, s/he does feel exploited, manipulated
and any number of negative feelings with and in spite of the most
well-meaning therapeutic presence. The client ‘knows’ first-hand
it’s bad because it’s going on inside them as an internalised
destructive pattern all the time. To maintain a warm, all-accepting
presence in the face of this boils down to side-stepping the negative
transference. The client ends up with having to choose between their
‘rational’ perception of the therapist’s good intentions
and their ‘irrational’ internal reality. If there is no
room for the internal reality to enter the here&now relationship
with the therapist, no spontaneous and lasting resolution is possible,
which is why I wouldn’t want to call such a process ‘therapeutic’.
On the other hand as soon as we want our therapeutic presence to have
an effect on the client, as soon as we have a therapeutic agenda or
goal, we enact the medical model which can be seen most clearly in
operation within the behavioural therapies. This maintains a subject-object
split which enacts the client’s objectifying relationship to
themselves. Any normative idea about therapy which requires the client
to be a certain way in order for the process to work clearly constitutes
a non-acceptance of how they are at the moment, which in most cases
re-enacts a habitual pattern of non-acceptance by significant others
in the client’s life and a habitual pattern of non-acceptance
within themselves. This is precisely what needs healing. To collude
with the non-acceptance by trying to therapeutically get rid of unwanted
aspects or produce more of the wanted aspects of the client’s
personality is therefore un-therapeutic. The equivalent ‘medical
model shadow’ in the Reichian tradition and in Biodynamic Psychology
(see my article in Self & Society: Relating to and with the objectified
Body”, Volume 27, No 1) is the attempt to use the body as an
avenue for undercutting the client’s defenses by one of two stereotypical
manouvres: • to provoke catharsis at a primal level by breaking
through resistance (‘armour’) • to undercut the pseudo-autonomy
of the social facade by nurturing the pre-verbal self This on the
one hand implies objectification of the body (through implicit idealisation
of the ‘core’, the ‘life force’, etc). But more
importantly it implies a denial of relationship, countertransference
and relational dynamics: it is impossible to undercut the client’s
defense without enacting in the transference the very object whom
this defense was established against in the first place. From within
the split the two polarities of the archetypal pair align quite neatly
into the following categories ..... As I have tried to illustrate
above, a theoretical resolution of these tensions is impossible. However,
it is my experience and belief that people in relationship can find
ways of being together in which these polarities are transcended.
I am reminded of Jung saying: We don’t resolve conflicts, we
grow out of them. I understand him to mean that we can get to a place
where we stop feeling pained and oppressed by them which does not
mean that the tension disappears. ...
Is business necessarily opposed to love ? There is a deep fear of
personal power in our culture - Robert Bly has called this modern
Western culture of ours the ‘sibling society’. We have lost
any sense that ‘authority’ can be benign, and have no sense
of there being elders which can help us through the transitions of
our lives through processes of initiation and liminal experience.
Whether we like it or not, as therapists we get lumbered with this
challenge to find wider archetypal roots than the stereotypal patriarchal
pair of Zeus and Hera, Apollo and Dionysus14
. I think the first task on the way, as I hinted at in the first part,
is to feel, hold and contain the pain of the split.