Monday, 20 September 2010

No Man Is An Island

Psychotherapy tends to consider itself discrete from the non-psychotherapy world. When we’re being psychotherapists and discussing psychotherapy we don’t also think about the gross domestic product of the country in which we’re working, or labour relations or what’s on television. There’re good reasons for this, not least being absorbed in the relationship between ourselves and our clients and yet we bring all those things – concern about paying bills, images from the news of war and mayhem, conversations about reform of the benefits system – with us into the room and so do our clients. Like our clients,  psychotherapists are individual people living individual lives that overlap into many different areas.

The life experiences of the psychotherapist – who has to fit too much in to the day in order to pick up her children from school (just) in time; who has to walk home at night through a potentially hazardous area; who worries about how to afford the car tax and mortgage repayments – will all inform the ways in which she is with people from different income groups as will the culture of the country in which she is born, raised and works, and lives.

I trained as a psychotherapist in a university where class and income were not covered at all and the make up of the group was such that only two of us from a group of 27 had any experience at all of living on state benefits or in social housing. This is inevitable in a system where training as a counsellor has moved almost entirely into higher education; where higher education is only available as a commodity that must be paid for; where universities are subject to market forces which are determined by the political processes in which we live and which we as individuals vote for.


Counsellors are expected to be reflective and reflexive about our work, we’re expected to reconsider our thoughts and feelings about ourselves, our clients and the relationship that develops between us. We’re given a vocabulary and specialized terms in which to frame reflexivity, which is undoubtedly helpful and can also serve, as all specialized language can, to obfuscate true meanings even from ourselves. This is especially likely when thinking about and working with people who are on state benefits.  A search of the literature shows that there is a paucity of research or even commentary on what has become known as The Underclass, itself a derogatory term, rather like calling gay men ‘Confirmed Bachelors,'

The socio-economic boundaries around counselling mean that counsellors are only ever likely to encounter people on benefits as clients rather than as peers which means that teaching about class, where it is rarely attempted, is purely theoretical. Although there are proportionately few non-white counsellors, non-white counsellors exist and can speak directly to the experience. The same can be said for gay, lesbian and transgender counsellors, counsellors who have experienced child abuse, domestic violence or drug and alcohol abuse. Those people who have the experience of long term poverty remain unrepresented and thus unheard.

This blog aims to offer an experience of living in poverty to counselors who have not had that experience. I hope that, if it doesn’t directly alter some of the commonly held opinions about the poor, it will add to the complexity of the so far very limited debate on how best to understand and work with an enduring experience of poverty. I don’t aim to be an apologist for every person who is living in poverty since every individual will have an intricate and complex multifaceted existence. There are, however, important parts of the life of being a person who lives with poverty that have a direct effect on our wellbeing, our view of ourselves, our view of others. Having an insight into some of these aspects will, I hope, offer food for thought.

A Short History of British Poverty

Historically, social responses to poverty tend to fall into two groups:
  • ‘relief’ of beggars and paupers
  • a profound mistrust and fear of the poor.
Queen Elizabeth the First was the first lawmaker to recognise the need for poverty to be addressed by society rather than by individuals. Prior to this, individuals who felt moved to help their neighbors did so but there was no obligation to. The Church, mainly through convents, abbeys and other religious houses, had offered shelter, food and at times work for the destitute but the Reformation broke this chain of support.

In 1563 the first Poor Laws were introduced which recognized for the first time that poor people were part of a community and that the community, in the form of the parish, must help support them. The system was funded by taxation and each parish was required to provide employment.

The poor were categorized into the deserving poor – infants, the very elderly, the very infirm and families who had temporarily fallen on difficult times; the undeserving poor who were considered a threat to society – beggars, travelers, migrant workers; the deserving unemployed – people who were able to work but unable to find employment.

It’s worth noting the political and social circumstances that preceded these laws. More people were simply remaining alive and there was less food. The Enclosures Act devastated the peasant farming tradition as private landowners found it more profitable to have sheep on their land rather than people, or to increase their personal area of farmland and decrease the number of individuals working it. Prior to the Enclosures Act individual family groups grew their own food in what we might call a smallholding, now they were simply turned out of their homes and made vagrant. Those that didn’t die of starvation or illness came to the city. The numbers of the very poor, the very weak, potential carriers of disease and the very angry increased and it was the fear of civil unrest that caused the Poor Laws to come into being rather than any inherent concern for individual welfare.

Laws altered over time, becoming more or less penalizing. Beggars could be whipped and have their earlobes burned through, be imprisoned and executed. They were returned to their own parishes, limiting where they could live. Houses of Correction, established prior to Elizabeth I and continued well after, were variously places where the poor were punished or rehabilitated: whatever the case, poverty is perceived as a fault that requires correction.

Reflections on Economic Theory

Economic theory is intimately bound up in how the poor are perceived and treated. Thomas Malthus published his hugely influential Essay on the Principal of Population in 1798. It went through a number of reprints and revisions but basically suggested that an increase in population must result in an increase in suffering of the poor via a depression in wages and decrease in food production. The book had a direct influence on how government treated the poor: famously, Pitt the Younger withdrew his bill for the extension of Poor Relief, something that Malthus advocated. Malthus was criticized for only applying his principals of reducing birth rates to the poor and, by extension, being uncaring of the poor. He replied:
I have written a chapter expressly on the practical direction of our charity; and in detached passages elsewhere have paid a just tribute to the exalted virtue of benevolence. To those who have read these parts of my work, and have attended to the general tone and spirit of the whole, I willingly appeal, if they are but tolerably candid, against these charges … which intimate that I would root out the virtues of charity and benevolence without regard to the exaltation which they bestow on the moral dignity of our nature…. (p. 607)
Malthus is clear that individual charity is necessary but doesn’t retract his stance that the population of the poor must be checked if the entire population is not to suffer starvation.

Victorian responses to poverty are well recorded by authors like Dickens. Scrooge in A Christmas Carol speaks for the general consensus:
Are there no prisons? And the Union workhouses? Are they still in operation? The Treadmill and the Poor Law are in full vigour, then? I was afraid, that something had occurred to stop them in their useful course. If [their occupants] would rather die they had better do it, and decrease the surplus population.
The pre-Christmas Scrooge pays his taxes which in turn pay for the prisons and workhouses and so he feels that he has done all he should for the poor.

The Industrial Revolution occurred around the same time as a further increase in farm size and a resulting decrease in numbers of farm workers. There were fewer jobs in rural areas but a massive increase in industrial jobs. Housing was at a premium and the simple economics of this situation resulted in huge areas of slums. Factories swallowed men, women and children at subsistence wages and with no employment rights. Abject destitution, starvation and disease flourished.

Adam Smith is best known for his Wealth of Nations, an economic model that has been interpreted in various ways. Before Wealth came a paper on the Theory of Moral Sentiments which seems to go against the popular concept of of Utility (The greatest pleasure for the greatest number) to suggest that
The ability to appreciate other people’s agony is achieved by the same parts of the brain that we use to experience pain for ourselves.
(Chapter 1)
Smith describes empathy in a curious, if unknowing, precognition of modern neuroscience.
He also famously advocates the free market. It’s well worth reading his work and commentaries on it, since his work has been ill-interpreted to suit political agendas. He absolutely does not promote a ravenous form of free market in which the sole aim is for the individual to become as rich as possible as quickly as possible without any concern for the consequences. Smith was deeply concerned with poverty.
. . . poverty, though it does not prevent the generation, is extremely unfavourable to the rearing of children… It is not uncommon… in the Highlands of Scotland for a mother who has borne twenty children not to have two alive… In some places one half the children born die before they are four years of age; in many places before they are seven; and in almost all places before they are nine or ten. This great mortality, however, will every where be found chiefly among the children of the common people, who cannot afford to tend them with the same care as those of better station.
1:8 para 37.
Charity, that is, the sympathetic involvement of the individual who is better off in the lives of the less well off, is a central aspect of his economic theory. Whilst individual charity was a central part of his own life and one that he advocated he also understood that
Man has almost constant occasion for the help of his brethren, and it is in vain for him to expect it from their benevolence only.
part 6, section 2, chap. 3, para. 18
He suggested, therefore, that the nation should also use its wealth to provide public works and in support of vulnerable groups.

It’s natural that when the economy is strong legislation around poverty is less punitive. Ruling groups, whether monarchy or government, have to be seen to be addressing a particular political issue. We see it in our own time, with debates about asylum seekers and an ‘indigenous population’, the rapid increase in numbers of unemployed people and an increasingly fractious debate about people on benefits. In the 1970’s when jobs in industry and manufacturing were decimated it was important for the unemployment figures to be reduced by almost any means necessary and a number of the long-term unemployed were put onto sickness benefit.

Psychotherapy and Money

Psychotherapy began as a private practice and thrives in a free market economy. A good number of psychotherapists treat their practice as a way of making a great deal of money from the unhappy wealthy. Every psychotherapist with a private practice will have come up against the ethical dilemma of wanting to be with the client in a particular way but hesitating because the client is a source of much needed income.

It is a fact that the profession is absolutely dependent on the poor as clients and that the poor are denied the opportunity to join the ranks of the profession. As the professionalisation of counselling becomes the dominant model so courses move from local colleges and into universities. University courses are obliged to become accredited by the British Association of Counselling and Psychotherapy (BACP) so tutor workload increases which in turn means that they can justify higher wages and so the cost of the course increases.

Students are required to gain at least 100 client hours and those hours are gained via counselling agencies that offer a low-fee or free service to clients – that is, those people who cannot afford private counselling. Which in turn means that people on a low income in need of counselling are also most likely to encounter the least experienced counsellors.

Agencies offer some supervision but a majority don’t offer adequate supervision, in some cases requiring that volunteer counselors first prove that they have a private supervisor before they’re allowed to offer their services. In addition, some agencies also require volunteers to show proof of personal insurance cover which costs at least £100. BACP membership at the time of writing is £60 a year for student counselors in receipt of state benefits. Psychotherapy courses start at around £2,000pa and can be as much as £15,000. A single person on Job Seekers Allowance gets around £60 a week.

Once qualified, many counsellors will continue to volunteer in order to gain experience as well as client hours towards BACP accreditation. Some of us will feel a kind of duty to continue offering a service to clients who cannot afford private counselling, and some of us will not. There are counsellors who on qualifying are given a Harley Street practice as a congratulatory gift from a spouse. In therapy today, the magazine for members of the BACP, there is the occasional classified advert for ‘Prosperous Private Practice.’

The Byzantine BACP accreditation process has created a new way of spending and making money: BACP accreditation workshops, paying supervisors or counsellors who are already accredited to help the applicant complete the process; the cost of the BACP administrative process which is at least £90 and which takes around 3 months for them to process, plus £110 more if one mistake is made. The ads at the back of Therapy Today have 2 pages of jobs, some voluntary, and 27 pages of CPD: counsellors making money from each other.

So money is absolutely central to the profession of counselling and psychotherapy and one that remains taboo. As one of the founders of  the BACP noted, it is the elephant in the room. Intimately entwined with this taboo is the way in which counselling perceives and works with ideas of poverty, class, income and what a ‘good life’ might be. This is so taboo that the BACP campaigns manager can write
. . . access to psychological therapy and/or support, with the aim of helping people achieve improved mental health and wellbeing, thus improving their ability to gain and/or maintain employment.
Robinson 2008:5
The above is from Therapy Today and as such represents the BACP’s opinion on the importance of the links between employment to mental health. Importantly, it also places the BACP in political relation to the importance of employment, suggesting that getting people to work is a positive thing for counsellors to work towards with their clients. Interestingly, this conclusion is not the one that the Royal College of Psychiatrists drew from the joint Department for Work and Pensions (DWP) Medical Research Council and Royal College conference.
Work is broader than ‘employment’ and should encompass voluntary work, home making etc. The majority of the research evidence refers to full time work whereas it might be more informative to consider ‘activity’.
Waddel 2007:5
Of course, what a client chooses to do in terms of employment or unemployment is none of the counsellors business, just as what a client chooses to do with an intimate relationship is none of our business. If the purpose of counselling is to allow a person to explore their lives and relationships in order to gain a better understanding and perhaps better mastery of their life then the counsellor must be very clear in their own mind about what their own expectations might be.

This can be difficult when the counselor lives in a society that equates poverty with victimhood at best and more often as badness, a position that isn’t helped when it’s 'common knowledge' that good mental health is helped by being employed and that the reverse is also true, that being unemployed results in poor mental health. When the BACP reinforces this, clients on a low income are doomed to second class work from counsellors.

Context Is Everything

A man is hanging out of the windows of the block across the road, he’s quietly telling a couple of children which door to go to and what to say. One the children, polite, neat and apparently confused, goes up to a door, looks back over his shoulder towards the man and says: “Is this the one?” I don’t hear any answer but the child raises his voice and says: ‘Excuse me. Excuse me. Do you live here?’ to the person going into the block. She doesn’t answer and the children wander off, back towards the other block where the man says: ‘See that car? Yes, that blue one, that’s it. Spit on it. Spit on it.’ The children, confused enough now to feel fear, walk away.

The man continues in his low, not unfriendly tone. ‘I want to fuck you. I want to fuck you. Oh, is that how it is now? Don’t you love me any more? I want to fuck you.’ My neighbours’ adult daughter comes into our block and we say hello. “Do you know that man?” I ask. She doesn’t, but he somehow knows her name and she’s more bemused than aggrieved. She goes inside, I carry on gardening, the man continues his monotone commentary. The children have long gone.

My daughter and I are walking home and we hear a cacophony of bird noises then see a blackbird fly out of a bush. There’s a nest in there with a second brood of fledglings and I take my daughter over to see it, high up above our heads in the municipal bushes. We listen to the young birds then hear an outraged: “Do you mind?” We can’t work out where it’s coming from, and again “Do you mind? I’m trying to go to the toilet.” And there, 4 feet from us squatting behind the large communal bins is a woman with her skirt pulled up around her hips. I am so shocked that I can’t find the urge or the words to reply and just leave, with no sense of threat but with the feeling that I’ve moved into a Kafkaesque world where squatting, shitting women are outraged that I’ve interrupted their public ablutions.

Across the road there’s a camper van, one of the cheaper ones and very old. The locks aren’t any good and a group of 10 year olds has broken into it. They throw everything out of it onto the street, bedding, pots and pans, a television, reams of paper, tea towels, everything. Then they cross the street and begin ripping a young pear tree apart, bending it under their combined weight, screaming loudly and intensely until the tree suddenly snaps and they land heavily. One boy is hurt and they begin to kick him. He has to get up or be beaten, staggers to his feet, laughs, throws a punch which misses and the lot of them move off down the street, leaving the road covered in the strangely unsettling contents of someone’s holiday life and the young tree. A number of us called the police who never arrive.

A family just up the road allowed their two elder children to smoke dope when they were 12 and 14 years old. The parents often went away leaving the three children alone, the youngest being 10, and they would have parties in which alcohol and illegal drugs contributed to the house being trashed, time after time. The 15 year old daughter started a relationship with a 30 year old whom her parents welcomed into the home and he tattooed her at 16 with her parents consent. On a school exchange the elder son made constant Nazi references at the two young German people staying with them which the rest of the family found amusing, and at 15 the youngest daughter put up pictures of herself on Facebook snorting coke.

Dee had what used to be called ‘emotional incontinence'. She felt she must share the most intimate aspects of her life with anyone who’d listen. Her partner who was over a decade older than her and demonstrably didn’t love her; her multiple, dramatic affairs; her children both of whom were taken from family home at the age of 8 to spend the rest of their childhood in special schools; the fact that her younger child has a close resemblance to one of her lovers; her eating disorders and self-harm. She had one job working as a nursery assistant and the rest of her life was spent supported by the State. Dee was killed in a high-speed, late-night, alcohol-fueled crash.

Context is everything. Dee is, of course, Princess Diana who is still treated with the veneration afforded to a saint. The family with dope smoking children live in a detatched home in huge grounds which means that neighbours don’t need to call the police to their rowdy parties and the underage sex and drug abuse is ignored. All of these people and families are worthy of our care and concern, but the woman who, with great dignity, squatted down in the hedge, the man in the council flat, the ‘feral children’ are much more likely to be dealt opprobrium, low-quality interventions and incarceration.
Why is that?

Them And Us

Counsellors function as part of society: as individual practitioners we hold differing political, social and personal opinions, if we didn’t there would be one psychological model and no professional debate. As members of society we are not immune from the concerns, interests and zeitgeist of that society and of course we bring all of that into the counselling room with us which is why counselling trainings are expected to address issues such as racism, sexism, homophobia, and disability awareness. Amidst the many anti-discriminatory trainings, class and income come very low down in training establishment priorities.

And yet counselling as a profession depends on people on low or no incomes. All of the agencies that student counsellors attend to gain experience and hours are attended by low or no income people because of the simple fact that they can’t afford to pay very nearly an entire weeks income for 50 minutes. In effect, low and no income clients service an industry that has demonstrated no real interest in them.

One of the reasons for this lack of interest is that low income people don’t train as counsellors.   All training establishments will all have some kind of equal opportunity statement along the lines of
It is our policy to contribute to equality and social justice by ensuring that all members of staff and applicants for employment shall receive equality of opportunity irrespective of sex, gender (including gender reassignment), sexual orientation, sexuality, race, colour, creed, religion, political beliefs, ethnic or national origin, age, marital status, disability.  [This university] is striving to break down barriers, extend opportunities and improve access to the resources of society.  It aims to reach out to all sections of the community as employees, students, clients, partners and suppliers.
People on low or no incomes are excluded from this statement. If an individual has the qualifications, aptitude and life experience perfectly suited for counselling training but cannot pay for the training she will not be accepted onto the course soley and absolutely on the basis of her income. People of colour, disabled, gay and elderly people do train as counsellors, have brought their experience to the training and challenged negative attitudes: there is no such challenge from poor people.

The experience of being in counselling has been researched over many years. We have some concept of client outcome, drop out and compliance based on statistical evidence and there is some – though very little – academic writing on the experience of the client herself. We all know from our own experience that when faced with people who have power over us we have to behave in a particular way. Incredibly, power dynamics in counselling are very seldom discussed in any detail in training or in academic literature though some counsellors will have some idea that this will be at work in all of our relationships. The experience of low income clients in counselling has been totally unresearched. Yet the low income client must contend with grotesquely unbalanced power dynamics in their everyday lives, simply to live indoors or to feed their children or buy sanitary towels. Behaviours and attitudes will form around this dynamic and these, consciously or unconsciously, will be brought to the counselling relationship.

The poor have always been discriminated against, in every period of history and almost every society. We hate Them. They are not Us. They function as something We can form our own identities around, defining what We are not. Despite being most often cited as a reason to be concerned about the poor, behaviour is certainly less important to society than economic status.


Francis looks 60 but is 42, a year younger than me. He wears the same clothes – clean and neat – to every counselling session and reeks of cigarettes to the point where I can barely endure 50 minutes in his company, the cigarettes taking up more space in my head than what he says. Over three sessions he talks about the damp kitchen and how the Council refuse to do anything about it, how he needs to be moved not only because of the damp, his asthma and sensitivity to noise but also because the house is such a mess. He can’t tidy it up because it always goes back to how it was. I ask him what he expects from counselling. “Can you get me a little holiday out of London?” I explain why not. “Can you write a letter to the Council, to get me a transfer?” I explain why not.

We don’t like each other at all and I can’t make much sense of the tension between us despite focused and helpful supervision. In our next session the client does something I find repellent: he pretends to cry. There are no tears and no snot but lots of sniffing, many tissues and glancing up to see my response which is to become more and more punishing. I become stiller, my face seems frozen into impassivity and I feel cold towards this man. I absolutely do not prize him let alone feel unconditional positive regard. Although not verbally congruent my feelings must be apparent and somehow I am unable to do anything about them.

If you need to access state benefits or get a roof of your own there are a number of things you must do, perhaps the most important of which is to learn to demonstrate how honestly pathetic you are. You must dress respectably but in worn clothes and keep your voice and eyes low. At the same time as filling in incredibly complex paperwork it’s necessary to do the equivalent of tugging your forelock, bobbling and cringing to demonstrate how worthy you are. Tears are part of this charade. You have reached the end of your tether, all is lost, please, please help.

Stereotypes of cringing, begging, whining people who are in reality prosperous because of their calculated undermining of the State while laughing at upright, hard working families, have a long and terrible history.
When we see the redundant population (as it is fashionably called) selected as the butt for every effusion of paltry spite, as the last resource of vindictive penal statutes, – when we see every existing evil derived from this unfortunate race, and every possible vice ascribed to them – when we are accustomed to hear the poor, the uninformed, the friendless, put, by tacit consent, out of the pale of society – when their faults and wretchedness are exaggerated with eager impatience, and still greater impatience is shown at every expression of a wish to amend them – when they are familiarly spoken of as a sort of vermin only fit to be hunted down, and exterminated at the discretion of their betters: – we know pretty well what to think, both of the disinterestedness of the motives that give currency to this jargon, and of the wisdom of the policy which should either sanction, or suffer itself to be influenced by its suggestions.
Hazlitt (1821)

Francis and I didn’t last long. I was unable to be compassionately congruent and found myself too close to repeating behaviours that I believe this client will have encountered before: disdain, dislike, swift and negative judgement. I came close to wanting to bully him. Counselling is a very different paradigm from central government support but whether we like it or not we remain in a perceived and often actual position of power over the client. Clients like Francis will have learned that people who are in power very often like being in power and have the power to block their client or to open doors.

My fantasy is that Francis, being under nominal attention from the mental health team, had learned that when he is depressed and cries he gets more attention than when he doesn’t. Because I wasn’t skilled enough to offer sufficient basic UPR or congruence a positive relationship wasn’t possible. It may be that Francis also lost interest once he realised I wasn’t able to support him in getting his external and genuine needs met. And I suspect he was as aware of the disdain that the ‘redundant population’ are held in as Hazlitt was.

External Locus Of Evaluation

Everyone knows that a person on state benefits is a bit shifty. Spongers, parasites, lazy, untrustworthy. Probably fraudsters. Everyone knows someone – or knows someone who knows someone – on benefits who has a huge television, buys designer clothes, has children littered about, has many children with different fathers, and who goes on international holidays at least once a year.

This is the overwhelmingly dominant paradigm in the discussion of people on benefits, and this group is treated in ways which, were they black or gay, would be simply illegal. It’s illegal to offer a flat for rent with the proviso of ‘No Blacks, no Dogs, No Irish.’ But it’s normal for a landlord to have the proviso ‘No DSS’. It’s absolutely acceptable to discuss people on benefits with as much hatred as you like, in the media, in the pub, at dinner parties, and in coded terms within education, medicine, social services, at the hairdressers, in a bus queue.

It’s acceptable to put a person on benefits under surveillance. Anyone, without the need for proof and anonymously can call the Benefit Fraud Hotline to report a ‘benefit thief.’ (How often is this done after an argument or relationship breakdown, spite being the motivation? The DWP keeps no figures on malicious reporting but the internet is full of anecdote.) DWP officers can put a person on benefits under covert surveillance taking long lens photographs of them, their children, their friends and their home life. They’re allowed to gain access to your bank account. Even if there’s no proof of fraud, a permanent note will be made on their records. People who have never had anything to do with the legal or judicial system or read a history book pompously reiterate the inane cliché ‘You’ve got nothing to fear if you’ve done nothing wrong,’

Imagine other groups under the same conditions: University lecturers’ bank accounts are accessed. Journalists are put under surveillance. The children of doctors are covertly photographed. The neighbours of Polish people are encouraged via advertisements on bus stops and on the television, to keep an eye on them. Just in case. It’s unconscionable. But counselors live and function in a society where we know that people on benefits are treated in this way and we don’t really care, even though most of us will work with people on benefits from the beginning of our training. 

How does living with the knowledge that you should be ashamed of yourself, that other people detest you simply because of your income, and that you are at threat of surveillance if you annoy someone, affect a persons self-concept and loci of evaluation?

This Pathetic Little Saga Of Mine

From a friend . . .
When I knew I was moving I rang income support and explained, they sent out a form (can NEVER remember the numbers they call them) but it was very brief, just a couple of pages to notify the new office in the area I was moving to) and that was all I was lead to believe I had to do, I was very relieved. Anyway it arrived promptly (Glasgow are pretty good, generally civil and competent) just before I moved.
Posted it off to the office they advised on the Monday (I’d moved in two days before). I also registered for housing benefit (they’d enclosed that form for me too). It was accepted but I was sent away with requests for proof of this, original of that . . . etc which I duly did. It took approx five weeks, included a surprise visit from a housing benefit inspector (who was serious but polite and conscientious) to verify everything and ask me a large number of the questions I’d already answered on the form before it arrived.
During this time, I phoned income support (twice)  to check the progress of  the transfer of my claim, they had no knowledge of it at the central office as the local one had not processed it, I was advised to give it a little more time and told he would look into it. A week later a completely new full claim form arrived for completion (three and a half weeks after sending the original notification). It is vast, more detailed than in previous years, soul destroying stuff but obviously I did it and sent it off. I waited . . . waited some more, received a letter advising me that my housing benefit had been suspended and I had x amount days to rectify the situation or reclaim (another form enclosed) before it would be cancelled…..urgh, what was going on?
I usually feel – having had to do a number of times over the years, due to the loss of a job or having another child – anything from victimised or unlucky, frustrated to paranoid because you do what you’re asked but inevitably it never seems enough, delays, being made to feel like a burden or a waster, repetition of previous information provided…..god, I’m tired just thinking of it!
So yes, no housing benefit because I was no longer in receipt of income support, a situation which I had created because I was the only person following things up and notifying the various department in the areas concerned, so NO rent, NO council tax and NO INCOME support. Child benefit yes but hardly enough to sustain us or keep my landlady happy and a roof over our heads! I phoned again, explained the situation again, was told to give it another week as they didn’t appear to have received anything, I wasn’t on the system…OH GOD! No question of if I could manage, wait til then etc. The following week, I phoned again, I explained again, and was told (again!) that they hadn’t received my claim, I was however, located on the system and there was a note advising that a claim for had been sent out on.
I stressed my situation, tears welling up, explained that I didn’t think I could manage any longer, she talked, I started to cry, I was in in luck, she was sympathetic enough to respond, took my telephone number, and offered me a choice of two options but because I was in such a state on the phone by this time, I can’t for the life of me remember what they were, suffice to say she was trying to prompt me to request (without actually saying outright) the option that meant they had to treat my situation as urgent and respond within 5 hours.
I was on the bus, three hours later when I got a call from a rather ‘sniffy’, ‘short’ woman who verified who I was and stated that my claim had been processed and a cheque was prepared, did I want to come into the office or have it sent out 1st class. I request 1st class, I couldn’t have faced going into them having cried down the phone earlier.  Anyway the cheque arrived the next day and I could breath again!
So, it took three hours to find, process and action my claim, after a period of 8 or 3 weeks, depending on which form you count from. All because I got someone who listened, and realised that something had to be done as I’d reached breaking point.
The bottom line is I didn’t shout loud enough, or hassle them frequently enough, if you are too polite, not assertive enough or just plain feel embarrassed or demeaned by the whole process then I don’t believe you get dealt with as quickly.
Does this all make sense? Tired and cold and thoroughly fed up by this pathetic little saga of mine!

Self Awareness

. . . the highly peculiar nature of the therapeutic project, whose very essence is typically that of self-interrogation and awareness – but which typically and uncritically takes the pursuit of that very process itself as an unproblematic given . . . therapy can be routinely and intrinsically abusive to the extent that it self-fulfillingly constructs a framework – professionalized therapeutic discourse and practice – which serves to guarantee the legitimacy of their own existence within a discursive regime of truth, and outside the confines of which it can become very difficult for clients and therapists even to think.
There is a long and intricate dance between the forces of standardisation and dissent and this dance is, I believe, central to the manner in which psychotherapy perceives itself and is perceived; its role in the voluntary, private and public sectors; the manners in which it offers itself to vulnerable people; and the manners in which vulnerable people are used to fulfil the training and accreditation needs of psychotherapists; the targets of the Health Service, the Department of Work and Pensions and central government; and the relationships between government and psychotherapy. It would appear that counselling is uncertain about its own societal status and purpose.

In a profession which holds relationship, empathy and positive regard dear discussion around the casual exclusion of people on a low income from being able to enter the profession, and the use of people on low income to facilitate the training and accreditation needs of counsellors is deafening in its silence. This is simply – as always in issues of discrimination – a consequence of the uses and abuses of power. It covers every aspect of the counselling relationship and is not limited to people on low incomes.
The counsellor just couldn’t understand what I’d been through. I spent 6 of the eight sessions just explaining what the religion was about and the way it worked.
Underhill 2008
I was given 6 sessions but I only went to two. She couldn’t offer me a time when I could go.
Personal  conversation

I couldn’t go, they didn’t have any childcare.
Personal conversation
One of the BACP Ethical Framework  ‘Values of Counselling and Psychotherapy’ is
Striving for the fair and adequate provision of counselling and psychotherapy services.
2007: 2
The ethics and practicalities of ‘fair and adequate provision’ is very patchily covered in the Framework and then only in terms of statutory provision and does not include the practised (rather than expressed) values of individual counsellors, training facilities and placements.

One source of information about the performance and behaviour of counsellors is clients, the people most directly affected. A lot of research has been done on clients – what variables affect their continuation in therapy, how their personalities change, compliance in rehabilitation – but I could find very little on what clients actually said rather than what the researcher thought they were saying. Further, psychotherapy publications tend not to focus on the clients experience of the world but on ways of managing the client.
Although there has been a steady interest in the client’s point of view it is still unusual to begin an investigation into the nature of counselling and therapy by looking at the world from the perspective of the client. Traditionally, one starts by describing the theoretical position of the therapist, or one begins by outlining the basis on which the client and her or his difficulties can be explained and treated.
Howe 1993:2

Self and Society

Person centred counsellors are members of a wider society and just as likely as non-counsellors to hold prejudices and beliefs about sections of society. We are taught a language and manner of approaching clients which may alter our way of being with people but which may not fundamentally alter our private beliefs about people. If this were not the case there would be no professional debates and there would be one approach to PCT. As it is there are differences of opinion, some polarised, about how counsellor and client should be together. (Saunders, 2003)

Further, counselling thrives within developed countries all of which operate a particular understanding of money and people. Although some counsellors might be emotionally content to exchange their time and expertise for food or services this is unworkable in a world where the counsellor cannot pay her rent in carrots.  An exchange of expertise, of counselling in return for, say, plumbing or accountancy, opens a chasm of ethical dilemmas some of which might be satisfactorily addressed if the imagination and will existed but would still isolate the unskilled. And counsellors charge very different fees for the same service.

British culture has historically had a punitive response to poverty and this remains the state of affairs today. Counselling as a culture discriminates against the poor at every level: do people who function within a milieu of reflexivity discover new ways of being or repeat the attitudes of most powerful voices around them? How? Why?

Counselling doesn’t occur within a vacuum and the life of the client outside of therapy is recognised as an important aspect of his wellbeing. (Sotsky 1991) Person centred authors all agree that equality and client autonomy are important but few address the foundations upon which this might be based. I’ve found that this discussion is most reliably to be found in Rogers original writings and in the work of those who worked with him. Rogers himself is clear that
. . . knowledge needs to be supplemented by experiences of living with or dealing with individuals who have been the product of cultural influences very different from those that have moulded the student.
1952: 437
Guilfoyle argues that

therapist and client are institutionalised “primary positions” that significantly, though often invisibly, regulate the circulation of power in the interpersonal dialogue, and thereby influence the production and shape of “secondary positions” in the client’s dialogical self.
Institutionalism is central to the issue. Old paradigms die hard.
Therapists are more likely to be white and middle class whereas clients are generally poorer, more disabled mentally and physically, older, younger, more dependent and less socially supported . . . people from oppressed groups who become therapists may take on characteristics of the mainstream group in order to survive and ‘pass’.
Proctor 2002:19
The introduction to the chapter Class Distinctions in Pilgrim’s book Psychotherapy and Society asks
. . . not whether psychotherapy is an elitist practice, but why 
The answer is, he suggests via historical, sociological and broad political discussion, that
The inertia in individual psychotherapists is part of a wider, cultural inertia within psychotherapy about lower class patients. The latter were rejected from the outset or were treated reluctantly or paternalistically as an addendum to the ‘proper’ work of engaging with fee-paying, middle-class neurotic clients and (later) special soldier patients. Ordinary working class civilians were rarely of any interest to psychotherapists of this century and their ability to pay shaped this to a large extent.

Job Centre

Counsellor training should include a mandatory trip to the Job Centre, not as an observing group but as individuals going in on their own, sitting in the waiting area, using one of the job search computers, experiencing. Very few counsellors will find themselves on the receiving end of the Job Centre and yet we train on those people who can’t afford to pay for counselling – largely the unemployed. Read the following for a vague idea of the experience.

Job centres have changed from the filthy, vicious halls of humiliation they were, spit guards protecting ill-trained people from the frustration of those they shamed. The proposal that spit guards be removed was greeted with howls of fury and fear from those civil servants who believed claimants were wild beasts. Strangely enough when the spit guards went the spitting stopped because the civil servants started behaving better.

Now, the physical environment isn’t bad at all: pleasant, open surroundings, staff with name badges happy to point you in the right direction and help when you’re kept waiting for your appointment. (If the claimant is late for their appointment they will be treated punitively. If the staff are running behind time it doesn’t matter.) But there are always people there who should not be. The levels of florid mental illness can be extreme. Confused shouting, attempting to comply, failing. Wandering weepers, being gently led outside. The staff have learned to treat these people gently because confrontation swiftly leads to often catastrophic (and entirely avoidable) violence. On one occasion, a demonstration of a peace pipe ceremony which brought out all kinds of staff outrage about indoor smoking.

People this confused or distressed are not suitable for work, they are probably entitled to much higher levels of benefit and certainly mental health input but because they haven’t accessed the appropriate service they just keep getting put through the unemployment system. Being unwell, they will miss appointments and get their benefits cut to £40 a week adding to their distress. Only when they become dangerous to others will they be given access to the mental health system.

Job Centre staff get 5 weeks training which evidently contains no discussion on not abusing power. Most are perfectly pleasant, happy to have a quick conversation about how optimistic you are. Never, ever be anything other than optimistic. Being realistic about your poor education, your inability to speak English, your depression simply switches on the disapproval. There are always one or two staff, very well dressed and with what they believe to be a professional manner, who make a point of being unpleasant. They’re bullies. The only way to get past them is to optimistically agree that you’re not doing enough, accept their banal advice and not point out that there is no ‘w’ in ‘counsellor.’

Job Centres do not exist to help anyone find a job. They are processing centres for the correct distribution of state benefits for the unemployed. As long as you go through the processes you will continue to get benefit. If you step out of the process you will lose entitlement. Getting a job is not the point, being processed is.

7 Days On The Breadline

Watching 7 Days On The Breadline last night was pretty depressing. The only adult man other than Keith Allen and Austin Healy was a 73-year-old grandfather. Young men, collapsed on broken chairs or in their un-linened childhood bunk beds, catatonic with depression and ennui, were frightened, conservative, finished before they’d begun. I found myself beginning to groan, “He can’t be bothered to sign on?! He can’t be bothered to give his mother some rent?!” and caught myself, just before “Bring Back National Service.” 30 years ago, these young men would have had a job in one of the manufacturing industries; now, they are entirely out of action. Without the educational and social background, there really is nothing for them to do.

(How is it possible for a child to go through school for 11 years and not be able to read, write and do basic maths well enough to get him a job? Yet this is increasingly the case for any number of children. Who has responsibility for them? Their parents certainly, but the reason we have schools is in recognition of the fact that most parents aren’t qualified to teach. Teachers have an endless litany about unruly children and lack of funding, local authorities will point to reduced funding and social problems as reasons why some children can’t be taught. And who is most affected by all this? The child who is left flapping at the end of everyone excuses, who then goes on to repeat the cycle.)

A mother of 6 in a three-bedroom house is shown to have no real desire to move. Stupid cow. The reasons for her reluctance aren’t discussed, possibly because the production team have no inkling that she’s anything other than a stupid cow. The reality is this: when you are on a very low income, change means disaster. Something always goes wrong in a move, the utilities aren’t turned on, the removals costs spiral, and if you have money you can deal with these things yourself. When you’re a tenant of a Council that doesn’t particularly care if you’re hideously overcrowded and have rats, you’ll probably have to live in the dark with no heating, lighting or hot food for some time. A friend of mine has been living without a kitchen for 3 months while the Council and the British Gas argue over who has responsibility for the meter.

Trinny takes the disabled pensioner to the Housing Trust so that she can move from her unsuitable home to a bungalow. She was put on the waiting and transfer lists. Result! Clever Trinny! Stupid old woman. No mention that she may well have to wait 10 years for a move.

It seems to be an accepted fact that the poor are lazy. Or is it simply a fact that when you have no money there is a severe limit to what you can do. You can’t go to the cinema. Going to a free museum or gallery means paying fares to get there and back, minimum, never mind having a cup of tea or lunch. You can’t buy decent clothes. You can’t pay for a decent haircut. You wait longer than usual to do the washing because going to the launderette is a pain in the arse and costs so much. The pointlessness of life closes in very quickly when you see your parent listless on the sofa, doing the cheapest thing possible – watching TV, usually without the license that costs more than a weeks income. (Would you pay over two weeks income to watch telly? Why should the poor?)

This programme simply serves to reinforce stereotypes of the stupid, feckless poor who can only be sorted out by the clever middle class. No concept of failed education, failed housing, failed healthcare, obvious depression remaining unaddressed. It would be fantastic to have a programme that gives a poor family a decent home, a good school, a fair income, a reasonably paid job and the mentorship to maintain this astonishing, unheard of state of affairs. But that might shake a few of our dearly held beliefs about the poor and how much better we are than they.

Wonderful Opportunities For Counsellors!

The October 2009 issue of Therapy Today, the BACP journal, led with the edifying news that "one in 6 therapists still sees fit to offer gay clients treatments that aim to make them straight" In the same issue comes the entirely uncritical piece “Work Is Good For You” a puff for government policy with added ‘Opportunities for Therapists’.

Counselling is splitting right down the middle; on one side people who enjoy the conveyor belt of uncritical engagement with everything from political strategy to their own practice, and on the other people who prefer to look behind the research findings, statements of what’s best for counselors, clients and society. BACP, the largest representative of British counselors, falls firmly on the side of convention. Where this affects the working conditions of articulate professionals the damage can be limited, not least by counselors leaving the organization. But where the BACP perceives vulnerable people as an ‘Opportunity’ we are on to some very dodgy ground.

The piece references no research on what makes for good mental health in relation to employment and yet the final sentence is “All [these opportunities for counselors are] based on the premise that work is good for your health and wellbeing.” They may be referring to the results of the 2007 joint conference of the Dept of Work and Pensions and the Royal College of Psychiatrists. The DWP reached a very different conclusion from the RCP: one decided that employment was good for mental health, the other than activity was. It doesn’t take a genius to work out which organization came to which conclusion.

Work is broader than ‘employment’ and should encompass voluntary work, home making etc. The majority of the research evidence refers to full time work whereas it might be more informative to consider ‘activity’.
Waddel 2007:5

In 2008, the BACP campaigns manager wrote another puff piece for the DWP

. . . access to psychological therapy and/or support, with the aim of helping people achieve improved mental health and wellbeing, thus improving their ability to gain and/or maintain employment.

Robinson 2008:5

Cui Bono? The BACP, like the majority of counsellors, wouldn’t dream of questioning assumptions around mental health and employment: counsellors might lose a source of income.

Governments of any colour don’t give a fig for anyone’s mental wellbeing, which is why our children are the most unhappy in Europe. What is important is that unemployment figures are kept low and in the past this meant encouraging people to move from unemployment to disability benefits. We are fed a constant steam of approval for ‘Hard Working Families’ not just working, but working hard, and virulent disapproval for ‘dole scroungers.’

Jung’s Red Book is number 3 on the Amazon bestseller lists, a rich exploration of a mans inner world, his spirit. As a nation, we’ve entered the machine world where peoples only value is in how much they spend and how much tax they pay. Today, Jung would join the other sensitive failures in a hostel, on sickness benefit, raving on a street corner and wouldn’t have a hope in hell of training as a counsellor. I doubt very much that with the state counseling is in, he’d have any desire to.

Brown, K. (2009) Work Is Good For You. Therapy Today October Vol.20 issue 8 pp17
Robinson, L. (2008) The Future Is Now. Therapy Today April Vol. 19 no. 3 pp4
Wadell, G. (2007) Employment and Mental Health. Absence from work due to mild and moderate mental ill health. Conference Report. Royal College of Psychiatrists.

Empathy and Experience

The article which had the greatest influence on my understanding of the role of empathy and shared experience in therapy was not academic or peer reviewed. It was a review in the Times newspaper of a biography of Lee Strasbourg, the creator of Method Acting. The famous anecdote of Dustin Hoffman in Marathon Man suddenly clarified my unease with many therapists’ statements on their empathy for people whose experience they share little of.

Hoffman spent three nights awake in order to play a character who was tortured by having his dental nerves drilled. When he arrived on set his co-star, Lawrence Olivier said, "Why not try acting? It's much easier." Hoffman was acting. By spending three days without sleep he was not experiencing torture, he had chosen to go without sleep in order to improve his performance. There is something about choice – and the power to be able to change that choice – that seems missing in the literature of empathy. An able-bodied person can choose to spend a week in a wheelchair, but if he’s in a fire he can get out and run. A person with a reasonable income can choose to live on the equivalent of benefits for a week or a month but they will not know the anxiety of being under neighbourly and state surveillance, always robbing Peter to pay Paul or the banal, recurring evil of an Incapacity Support Tribunal.

Thoughts from a single parent, benefit-dependant friend:
All I would say is that it doesn’t matter what profession a person is in, if they haven’t got any first hand experience of what it is like to be on a low income, especially over a long period of time (images of Portillo living the life of a single parent for a week spring to mind here), then they do struggle to appreciate the various ways in which it can impact on ones life and that of your family. Those that say they do – lip service.
The majority of people who need help are from the poorer sector and either can’t afford it, aren’t offered it, may not even be fully aware or have sufficient understanding of how it works or how it could help them AND if they do, often it will be a trainee so they might not receive a decent standard of counselling.
Don’t her statements demonstrate some of her ‘issues’? Won’t the therapeutic relationship work these issues through? Does it matter if she’s right or wrong? Maybe, maybe not. Personally, I have great faith in the Person Centred therapeutic relationship but it has to be based in a genuine and full-blooded foundation rather than one entirely dependent on funding for 6 sessions.

The pat answer to the question of empathy is that we all share similar experiences and can use them to empathise with the experience of the client. There’s some truth in this but the existence of specialist support groups speaks to the importance of the truly shared experience. People can communicate in intimate shorthand without having to explain or pull their punches for the sake of the listener, a shared journey with close companions, people who don’t need to be orientated within the experience or told everything for there to be a sense of kinship.

Connection has been categorised and simplified, codified and reduced to a technique. “You can empathise with a woman who’s lost her baby because your dog died.” Not really. One of my peers wanted to prove that online counselling was able to provide Buber’s I-Thou relationship between client and counsellor. That this person wanted to prove anything in research was a measure of her need. Despite discussions she went off and did the research which demonstrated that an I-Thou relationship was indeed possible in online counselling.

Buber spoke of moments of I-Thou relationship, brief (but timeless) instances beyond speech touching the realm of mystery; fragile, unrehearsed, attuned to agape. This goes beyond empathy into the realms of perfect love and perfect trust, connection rather than relationship, existential meaning-making and life purpose.

Buber is wonderful to read: dense, rich and complicated it takes time to absorb his wisdom. There are many other authors who build on his work and create their own whose writing is accessible and not in the least mystical without losing any gravitas or wisdom. Working at Relational Depth by Dave Mearns and Mick Cooper brings together the philosophy and research into client/counsellor connection and challenges counsellors to viscerally connect with the experience of the client.