Author Topic: British State Regulation of Psychotherapy and Counseling  (Read 5972 times)

Matt Koeske

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British State Regulation of Psychotherapy and Counseling
« on: May 13, 2009, 05:19:40 PM »
I recommend to anyone interested in either ethics or sociality issues in psychotherapy that you check out Andrew Samuels' website.  Samuels has a video "rant" briefly outlining the problem of impending state regulation of British psychotherapy and counseling, but also showcases three very interesting presentations at the conference of the Alliance for Counselling and Psychotherapy - Against State Regulation (the first of these is given by Samuels).  The webpage of the Alliance can be found here.  Andrew Samuels site has information on the Alliance here.

Before I go on, I would just like to add an aside regarding Andrew Samuels, who is a "developmental" Jungian analyst and scholar who authored the very important Jungian Book, Jung and the Post-Jungians (1985).  In this book, Samuels (at the time very boldly) delineated three schools (or what I would call tribes or sub-tribes) within Jungianism.  He followed up this publication with an essay entitled "Will the Post-Jungians Survive?" (1998) revisiting the tribal "migrations" in Jungians that took place since the book had been published.

I very much like Samuels' attempts to bring consciousness and emotion/ethics to the subject of tribalism in Jungian psychology (and British psychotherapy in general).  I also appreciate his efforts to construct a web presence.  Along with Canadian Jungian analyst John Betts and a handful of others, the individual Jungian web presence isn't exactly growing, but it can be said to exist (and by web presence, I mean Jungians who are actually offering something on the web more than just a website advertising their practices).  What I like most about Samuels is that he is willing to be confrontational.  He is more of a "centrist" than I am, of course, but I think he is doing the right or necessary thing . . . and of course every Jungian is probably more of a centrist than I am  (-)howdy(-), so that can hardly be counted against them.

I suppose my desire would be for some bridge-building to occur between Jungian centrists of any tribe and the "wilderness" where folks like me eat our locusts and honey.  And the web is the ideal leveling medium for this.  The idea I mean to promote is that the professional Jungian establishment suffers from having no link to the shadowy unconscious of its personality in the same way that an ego can become so identified with its persona (or Demon) that it loses touch with the instinctual Self/unconscious.  In this metaphor, Samuels would be like an emissary of consciousness (ego) that is hanging out a shingle in the Jungian unconscious (John Betts is hanging out a shingle of a different kind, one that still seems a bit prohibitive to the Jungian shadow).  As for me, I am on the other side of the water, hanging out my shingle for the Jungian shadow.  I try to give voice to the Jungian shadow yearning to come into contact with the illuminated Jungian consciousness, and Samuels tries to give a voice to the Jungian ego starting to feel a need to find its own shadow.

Samuels takes two stances that are conducive to attracting the Jungian shadow back to the realm of Jungian consciousness: 1.) he reflects on the social or tribal behaviors of Jungians (a subject Jungians have always struggled mightily with and typically bungled or repressed) and 2.) he brings argumentative affect and ethical stance to many Jungian and psychotherapeutic issues.  I have stumped a few times for the inclusion of more-affective voices in Jungian thinking, and I'm not really sure what people who have read these things think or what many Jungians would think if they heard these opinions.  I see affect, ethics, and Eros as inextricably connected.  And therefore it makes perfect sense to me that three major issues in the Jungian shadow are affect, ethics, and tribal participation/differentiation (what I often call tribal Eros).

Of course, as self-appointed shadow-advocate I have sought to give voice to these issues with shadowy, reactive, compensatory excess.  Samuels has been more balanced, as his station and persona would dictate.  But he has spunk (better recognized in his presentations to groups than in his man-to-camera video podcasts, which feel penned in somehow), and I hope this affective/ethical stance will continue to spread in him and draw him closer to the Jungian shadow in other arenas.


But for now, back to the state regulation of psychotherapy.  The three conference presentations Samuels hosts on his site can be viewed on his Video Lectures page.  Each is compelling in a different way.

I'm not going to do an op-ed on this issue.  I'm not really well-informed enough to do such a piece justice.  I will just say a few very general things (mostly abstracting from the issues the presenters discuss rather than commenting on the presentations directly).  First of all, the idea that psychotherapies should be state regulated (in the UK or anywhere else) strikes me as a simply terrible idea.  I would expect such a state movement in some kind of totalitarian dictatorship, where no one had enough freedom and power to resist it . . . but how could something like this look so possible, so probable, in the UK?  Well, it seems that not enough British psychotherapists have been willing to stand up against this government push (I'm sure this isn't the only reason for the probability of the state regulation, but it's the one I'm most concerned with).

Essentially, as obnoxious as the government's program for regulating psychotherapies is, the deeper problem is that psychotherapists in the UK are not adequately standing up to oppose this or to band together with other opponents in the profession.  What's more, according to what conference presenter Haya Oakley said about the history of regulation of psychotherapies in the UK, Psychotherapists initially brought this problem upon themselves when they turned to the government to acquire some muscle to banish scientologists from their turf!  That's one of those anecdotes too novelistic to make up!

I look upon these various psychotherapeutic schools and organizations as tribes competing for the same resources (albeit in a resource rich environment in which competition is not truly cutthroat, at least not by necessity).  With state regulation of the profession impending, a new power has "colonized" these resources, this shared land . . . and the tribes are being compelled to scurry to be the first and best to appease the colonial occupier.  Handled unconsciously and without adequate foresight, the tribes will turn upon one another.  Tribal prejudices that have lingered for decades but were not significant enough to act or dwell on, suddenly become important.  Tribal differentiation is accentuated.  From the totalitarian colonial power's perspective, this is advantageous, because it channels such tribalism into a self-regulation and "normalization" of the system even better than a strict enforcement of laws might.  As long as tribal competition is high, appeasement of the colonial power will be high.  I.e., get the occupied tribes to fight among themselves and they won't be able to functionally organize to fight against the occupying power.  As this develops, more backing and resources are allowed to trickle into the coffers of those tribes that best facilitate the power and control of the occupier.

This is an ancient political strategy of the powerful (and it has lasted because it works so well).  What is both fascinating and disgraceful is that the collective of psychotherapeutic professionals has not unanimously (or perhaps even in a majority) recognized this stratagem and the inevitable fallout and destruction it promises to the whole profession.  To be more precise, it is not, I think, that they haven't recognized the stratagem, but that they have, in spite of this recognition, still allowed old tribal prejudices to drive them like the proverbial lemmings toward the drowning sea.  What Samuels and the other members of the Alliance Against State Regulation have been trying to do is form a collective body of protest that has enough power to raise consciousness in the greater psychotherapeutic community and to ward off the impending state regulation.  This is extremely exciting (I think, and I suspect the members of the alliance agree) because not only does this represent a "good fight" and a necessary act of survival, it defies the tribal prejudices that continue to plague the profession by bringing tribal "enemies" together under one organization.  The Alliance acts as a kind of melting pot where others are mixed together and faced with the issues of their otherness and the otherness of their fellow members.

Such a melting pot (on a much smaller scale) is what my own vision has been for Useless Science.  Yes, I want to pursue my agonistic and individual path as a psychological theorist, but no, I don't really want to do this in a vacuum.  Yes, I am critical of Jungian classicalists, Jungians New Age spiritualists, and (more recently) Jungian developmentalists or psychoanalysts, but no, I do not in any way want to exclude them from voicing their opinions or exploring their ideas here at Useless Science (in fact, I would very much like strong advocates of these and other schools of thought to challenge my claims and criticisms).  Useless Science has been a platform for my personal theories not by design but by default.  The intended design was to bring various kinds of depth psychology thinkers together with the single qualification for all being a commitment to intellectual rigor (and hopefully, an open mind regarding the opinions of others).  I started this site as a kind of anti-tribal (although generally Jungian) forum as a reaction against the very tribalistic Jungian forums that predominated on the web.  Although the tribes populating these forums are not representative of the professional Jungian tribes, the quality of tribalism itself is also a professional Jungian problem (and I have always seen Useless Science as a reaction against that tribalism, as well).

Useless Science is and will remain unaffiliated.  It (and its admin) do not belong to or clandestinely champion any Jungian splinter tribe.  I have said this before, but I still often get the feeling (intuition? paranoia?) that people passing by this forum feel they must be like-minded (to me) in order to participate or be welcomed.  I have never met another Jungian so like-minded to me that I would consider us true tribal "kin", and that is not what I'm looking for.  What I hoped to find or help establish was a venue for Jungian otherness and innovation.  I think I personally qualify as such an "other" in both good and bad ways . . . and I think there are important ideas out there in the greater Jungian community that are either not expressed or not refined/evolved because they are never exposed to a group of diverse thinkers.  My own theories qualify here, as well, as they clearly suffer from a lack of astute and critical input from others.

Of course, there are many cranks among the Jungians and quasi-Jungian fringe (and some of these have showed up on various Jungian forums at least briefly).  I can only assume that I am taken as a crank by those Jungians who find my ideas and statements shocking, heretical, or merely half-cocked.  But it is not my intention to house and enable cranks and fringe wackos who mistake their delusional inflation for genius or special insight.  What I would like to enable is the sane thread of shadow-advocacy and dissent that is submerged in the affect of both fringe cranks and the bothersome little voices of the indoctrinated Jungians that don't get to "grow up" and find a threshold of initiation because they are too unwanted in the Jungian tribe.  That "initiation" is only available through the ethical and dedicated interaction with others.  My very point is that Jungians have discarded good ideas, stances, and personality structures into the collective shadow, and these things need a chance to be both animated and tested to prove their worth.


To return to the Alliance Against State Regulation, we see an anti-tribal movement born out of necessity, the same necessity that also illuminates the extreme tribalism among psychotherapeutic schools.  Well beyond Jungianism, tribalistic fracturing and dogmatic totemizations choke the whole profession.  I have been primarily interested in Jungian tribalism, as I see myself as affiliated with the (greater) Jungian tribe, but there is no doubt that all formulations and schools of psychotherapy are tribalistic.  What the situation in the UK projects in huge glowing letters is that tribalism in this profession not only often outweighs common sense, it also threatens the survivability of all psychotherapeutic professionals.  Tribalism (where it is unconsciously pursued by these professional organizations) is dangerous and non-adaptive.  It does not have a viable response to modernism . . . as is evidenced in the significant number of British psychotherapists who have backed or at least turned a blind eye to state regulation.  This means that the psychotherapeutic tribes that will survive are those that are willing to be conformed even against their own sense of autonomy and ethics.  Integrity is sold for power . . . and regardless of whether or not these specific schools of psychotherapy have "Good Medicine" to offer patients, the backing or acceptance of state regulation is not a decision made in support of patients and their rights and wellbeing.  Rather, it is a subconscious or passive aggressive maneuver against the other psychotherapeutic tribes who have always aggravated the regulation-accepting tribes simply by not going away and by serving as at least token competitors (where a token competitor is really just someone who believes in a different god).  The empowerment of the regulation-backers is really an empowerment to deal severe blows to tribal competitors (which will be done in the interest of those institutions and companies that profit from such normalizing state regulation . . . in the US, this would be the drug companies and health management organizations, but I'm not sure how this would play out in the UK).

The Alliance is an attempt to bring the state of sociality in this profession into consciousness and respond to its unconscious tribalism in a conceptualizingly adaptive way.  And it is worth reiterating that this alliance was born out of necessity, out of the need to survive.  That is, it is driven by instinctual affect . . . perhaps in a way similar to that in which the heroic attitude wells up out of the affect of the Self system driving for reorganization in the personality.  I don't mean to glorify the Alliance as truly "heroic" (I really don't know enough about it).  I wish merely to note that this movement toward ethical consideration of otherness has developed out of an instinctual need for survivability.  The instinct in question is part of the Self system's organizing principle.  So we might see it as ethical in this situation, but it is primarily self-protective or self-sustaining in its reactive organization in the name of mutual survival.  Consciousness from instinct . . . or we could say with Democritus, "Nature delights in nature, and nature conquers nature, and nature masters nature."

I hope that Jungians, whether working in the UK or not, will take the struggle of the Alliance Against State Regulation and the issues it brings up both directly and indirectly to heart.  It is time to reflect both on our tribalism and on the serious problems of our survivability . . . and how the problem of survivability puts us on a kind of ethical chopping block where we must confront our social or tribal impulses and decide whether to act ethically (consciously) or not.  In that decision, we are faced with our own shadowed desires to act selfishly and unethically (perhaps for short-term "egoic" gain), yet we should also be able to see that long-term loses present an even more terrifying prospect.


You can always come back, but you can’t come back all the way.

   [Bob Dylan,"Mississippi]

Keri

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Re: British State Regulation of Psychotherapy and Counseling
« Reply #1 on: August 27, 2010, 08:44:17 AM »
Matt,

I would like to try to comment on this at some point soon.  Can’t do it right now – not enough time and my thoughts on it are still too fuzzy and indistinct.  But it is very important to my personal Work right now.  My thoughts are more about American medicine.  These are things I’m trying to differentiate and tease out.

Tribalism in American medicine
- Already a lost battle for many other types of medicine, at least regarding reimbursement (allopathic medicine vs others like osteopathy, naturopathy, homeopathy, Traditional Chinese Medicine, etc).
- Interspecialty battles for resources

Regulation in the form of standards of care, guidelines, reimbursement for services
- Is this a good thing? – more evidence-based, more safety for patients
- Is this a bad thing? – forcing conformity and one-size-fits-all practice with punishment (in the form of lawsuits or loss of licensing) for those deviating from this standard

Who decides?
- Insurance companies
- Drug companies who pay for the studies
- EMR vendors
- Practitioners
- Patients

How to tell when you are being “ethical” vs “Demon-like”

Keri
O gather up the brokenness
And bring it to me now . . .

Behold the gates of mercy
In arbitrary space
And none of us deserving
The cruelty or the grace

O solitude of longing
Where love has been confined
Come healing of the body
Come healing of the mind
  - Leonard Cohen, "Come Healing"

Let me be in the service of my Magic, and let my Magic be Good Medicine.  -- Dominique Christina