Sunday, 2 October 2011


    . . . Personal narrative is all we have, whether as individuals or a society.
Like any narrative the Western self-view is riddled with contradiction. Decisions rarely have anything to do with the rationale that supposedly provoked them. And as with personal narratives, what does not fit is conveniently ignored. The difficulty for anyone who tries to step outside the dominant narrative to present a different view is that we cannot, by definition, provide the ‘evidence’ that is required by the narrative that demands such evidence – a bit like going into the pub at 10pm on a Saturday night and preaching the benefits of sobriety. Neither can we provide evidence from within that narrative. The minute we step back into that world we are governed by its conventions, and any attempt to explain ourselves becomes a nonsense.

William Johnson
Therapy Today March 2008

This blog has been a personal journey of exploration into the relationship between social justice and counselling and I wanted to share some of what I discovered. Some counsellors, I’d say about 10, have shown a positive interest. It feels as if I’m William Johnson’s person in the pub at 10 on a Saturday night preaching sobriety: it’s a waste of my time. Counselling as exemplified by the BACP, if it makes any acknowledgement of it's relationship with society at all, is dismissive and contemptuous of anyone who suggests that counselling might look at the way it perceives and relates to itself and to people with far less power.

In today’s Times Dr James P Smith writes about nursing, a career that includes a goodly number of excellent nurses and which prides itself on it’s professionalism but en mass seems to ignore the experiences of the huge number of patients who’ve been brutalised and neglected, often to death whilst in their care:

As a Fellow of the Royal College of Nursing since 1978 . . . I want to thank you for your editorial in which you finally explode the myth that there is a shortage of qualified nurses in the NHS. We have come a long way since 1956 when I was a young staff nurse on a 46 bed cardiothoracic unit, working five nights a week on 12 hour shifts. In spite of the intensity of our work all our patients got an early morning cup of tea. 
Even though the Royal College of Nursing knows it and the Times knows it and a great many nurses know that understaffing is not the issue the profession of nursing still falls back on understaffing as the reason why so many patients are suffering unnecessarily rather than taking a brave look inwards.

Thankfully, counsellors are nowhere near as important as nurses. Whilst we have many excellent counsellors our exploration of ourselves as people with power over people with less power is academic where it exists at all. Yes, BACP Professional Standards offer a useful tool for sanctioning counsellors and the fact that they name counsellors who’re sanctioned suggests they’re interested in humiliating individuals – do you make note of those people named and shamed in Therapy Today to ensure that if ever they darken your agencies door you can shun and denounce them? Yes, the Ethical Framework is valuable and well thought out but the BACP doesn’t apply it to itself. Letters, if not totally ignored, will be condescendingly responded to ‘in due course’ and apparently the BACP has always functioned perfectly; if any changes are made it’s not because anything may have been inaccurate or done badly.

For me, that the BACP can stand outside of the decades of debate, politics and struggle that surround the issue of abortion to support the recent Dorries/Field amendment solely on the basis that, like the punitive DWP proposals which it also supported, it offered ‘increased opportunities for counsellors’ is a reflection of counselling itself. It doesn’t matter how or where the money comes from, we’ll work for anyone under any circumstances as long as we can clutch tightly to the status and identity of ‘counsellor’. I'd be interested to know if we have any limits at all.

Have a look at counsellors social network profiles. Many only communicate in Inspirational Quotes, almost all are written as if by experts responding to people who need this counsellor’s knowledge and experience. Some are written as if the potential client is a sad idiot in need of sympathy.

A great many counsellors are probably very concerned about social justice but clearly there are not enough. Organisations like the Independent Practitioners Network have a committed core of highly experienced (and ageing) members who value functioning face to face rather than paperwork to bureaucracy and inevitably have a minute membership. They're not concerned about competing, they're vitally interested in relating - and prove it. 

I'll put a fiver on most counsellors never having heard of them.

The BACP deny monopolising counselling but why then, in the face of 1 in 6 BACP counsellors feeling fine about ‘converting’ gay people into straight people, and BACP accredited counsellors being most likely to abuse their power with clients, do they have the greatest membership, with non-counselling and counselling organisations alike employing only BACP accredited counsellors? It is not, be assured, that BACP accredited counsellors are always the best. It is because the BACP is a glossy, hugely marketed presentation of acceptability and safety which openly suggests that non-BACP counsellors are unprofessional, unsafe, and unacceptable. And you and I as individual, responsible people allow that.

Even in the teeth of raging and increasing poverty, charities providing British families with food, social unrest that made news across the western world, an increase in suicides linked to benefits, UN recognised child misery and a national reading age of 7, counselling has absolutely nothing to say about any of it. We stand above it all, perhaps watching as interested observers of rats in a cruel experiment, uninvolved unless it might offer us an 'opportunity'.

So here I am, in the pub on a Saturday night or rather, a tightly packed morgue. There are some very important rules to follow and one or two people are not in drawers with a sheet over their head able to hear and talk, but as we chat my breath evaporates and I wonder what on earth I’m doing, spending my time in a morgue on a Saturday night.

Thanks to those individuals who’ve commented, popped in or promoted my work over the last two years. Were it not for you I’d wonder if there was any vitality left at all in counselling. My final statements here are: Who’s benefiting from our current way of being? and, Follow The Money.

Wednesday, 28 September 2011

Knock Me Down Wiv A Fevver!

Kelvin Mackenzie teaches about the empathy gap.

Still, I do reflect that in those 60 minutes I spent with the two police officers by Putney Bridge that my previous hostile attitude to the hacked stars had changed forever.

Mackenzie isn’t known for his sweet and understanding nature but he perfectly describes that moment when the veil drops.

For the first time I felt uneasy. If you have been editor of the Sun for 12 years, if you have floated and run a public company as founder, chairman and chief executive, very little worries or concerns you any more; your nerve endings have become encased in cement. But oddly I felt quite threatened by this invasion and understood more clearly why celebrities — no matter if they were A or Z listers — felt they had been violated.

Earlier this week Online Events broadcasted an interview with Sandra Grieve and Lucia Berdondini on teaching counselling skills in a war zone. It was fascinating, very real and very simple; with language being one of many differences between these women and the people they were teaching making relationship became fundamental.

They were quite clear that on returning to the UK they experienced an empathy gap. After living and working in environments where life is cheap and intense it can be easy to dismiss concerns that don’t compare. Both women accepted that empathy gap was simply part of their process. They didn’t pretend that they could bypass it but quite comfortably said that they had to be alert to it.

Here’s one study on the empathy gap which suggests that

. . . people have difficulty appreciating the full severity of social suffering unless they themselves experience it.

Honestly, I don’t know how better to address this in relation to class, income and counselling. Counselling couldn’t be less interested in social justice. The August riots consumed every part of the media, directly affected thousands of people and indirectly effected the entire nation but remained unmentioned in Therapy Today. If homes in flames and looting children don’t pique counsellors attention I’m not sure what will. Empathy gap indeed.

Thursday, 25 August 2011

The Depravity Of The Poor Means That They Can Be Killed.

This blog doesn't get so many hits and as far as I know, it's the only one of its kind. It seems to me to be indicative of the state of counselling: talk about the latest research into the amygdala and there'll be some interest from counsellors. But the tsunami of poverty, anxiety, sheer misery that's sweeping the country doesn't seem to have the same urgency as, say, becoming a coach. Never mind that the state of the amygdala and the misery so often caused by poverty are often linked.

Never the less, a steady number of people do drop in here, and I'm grateful to you for that. It does feel as if I'm speaking into the void most of the time. But rather than join the apathy, I'm going to continue to post about the results of blank bureaucracy on the most vulnerable.

After returning a verdict of suicide at Westminster Coroner’s Court on Tuesday, August 23, Dr Fiona Wilcox said: “What I find particularly tragic in this case is this act appears to be pursued by a man who was not suffering from an illness and appears to have made a considered act in response to his inability to find employment. 

“The fact his housing benefit was about to be cut and the family would be at risk of having nowhere to live, and being ordered to give up his training course because of job centres rules, would appear to be especially poignant and tragic.” 

Or evil and catastrophic.

We can imagine some of the misery that Mr Sanderson endured before he succeeded in killing himself and some of it will have been caused by attitudes such as this:

"It is simply a fact that our social problems are increasingly connected to the depravity of the poor. If an American works hard, completes their education, gets married, and stays married, then they will rarely — very rarely — be poor. At the same time, poverty is the handmaiden of illegitimacy, divorce, ignorance, and addiction. As we have poured money into welfare, we’ve done nothing to address the behaviors that lead to poverty while doing all we can to make that poverty more comfortable and sustainable."

David French is honest enough to say what he believes which is what a great many people - by no means just Americans - believe, including some people who are poor. Which ignores poor people in stable relationships, without addictions or who may be innately more intelligent than a person with more income who has greater access to decent education or, after 16, any education at all.
We've heard a great deal about how the middle classes have begun to live hand to mouth but this is how people on a low income have been living forever. Mr Sanderson would not have been looking forward to becoming homeless with all the endless running around after bureaucrats that would have come with it. But I think it's fair to say that shame and humiliation would have had something to do with his sane decision to kill himself. Perhaps these feelings were amongst those that Christelle Pardo had as she held her child and jumped to her own and her sons death. Jenni Russell:
On websites there is a striking lack of sympathy for the Christelles of this world, and a marked resentment about the number of people demanding our collective help. 
It's quite clear: Christelle - and all the other women with babies who've been made homeless and destitute by the State, and all the men who are despairing at the thought of their families becoming homeless, and all the women wondering just what more they can do, since missing two meals a day still isn't making ends meet - can go to hell, and good riddance. 
If someone had stabbed Mr Sanderson twice in the heart, or pushed Ms Pardo and her baby out of her fifth floor flat window, or lynched a disabled man there'd be outrage from every media outlet and politicians making hay from it. But no one at all actually cares when it's done legally. Because they're poor.

Tuesday, 16 August 2011

Post Riot Musing 2

So rather than curse the dark perhaps I'll light a very small candle instead.

The Parliamentary Debate in response to the devastating riots of the last few days is on in the background as I write this and I wonder why I’m listening to it at all. Each speaker seems to have a script, saying things that they believe will appeal to voters; no one seems to be able to say anything that isn’t rhetoric.
I live in one of the areas very mildly touched by rioting: some shop windows smashed, a couple of restaurants raided and the patrons mugged, some vehicles torched. My daughter and I watched TV incredulously as Reeves’ furniture shop in Croydon became an inferno that spread to family homes. We packed a small case with passports, paperwork and a change of clothes and wondered how the cat might fare being dragged in a box to the local mosque, our nearest community place of safety. By 1am our area was quiet and we went to bed feeling safe.
The following day opinion exploded. There’s little point in repeating those opinions, we’ve all been exposed to them from every media, from friends and relatives, people at bus stops or anywhere else people might stand still for more than 5 minutes. We will all have our own opinions too. For me, what really stands out, what unites every opinion, is that everyone feels unheard.

I’ve watched and participated in any number of conversations on what looting might mean, how it began and how to deal with looters. Friends have fallen out and I’ve found myself very severely challenged by friends who quite genuinely want to give police a shoot to kill policy, to bring water canon onto the streets or, in more than one case, have suggested that all media should be shut down for a period of time and the police be encouraged to batter anyone they can get their hands on to death. “If they’re on the streets they’re fair game,” as one friend said. My instinct has been to terminate those friendships, I don’t want my social circle to include people who sanction brutal murder or a police state. But in a slightly altered state of shock, some fascination and the desire to test just how much a counselling-type approach to these horrific statements can perhaps create space for a more nuanced discourse, I’ve tried not to reject any but the most racist, ghastly comments.
Listening and responding carefully to friends has revealed that in a number of cases they’re actually yearning to move beyond concepts of vengeance but don’t know how. They know they want to be involved and, as every radio and TV programme and website seems to demand, Have Their Say but have no concept of what that really might be other than advocating extreme punishment. We’ve sometimes found ourselves at odds because the assumption has been that if I don’t want to visit violence on a looter then I must automatically want to make excuses for them. Most of my friends are middle aged, middle class and educated but I’ve found myself shocked by the poverty of genuine debate: worse, the apparent inability to debate. Absolutist statements - “Parents/police/ government/ liberalism/ intollerance are to blame.” “This is/ is not a race issue.” “Poverty is/is not the cause,” are clung to like life rafts, without them people seem helpless.
Happily this hasn’t always been the end of the story most noticeably with younger people a number of whom begin with a statement along the lines of “Take benefits and council houses off looters,” and then are genuinely interested in engaging when I ask about the teaching assistant, the law student and other professionals who’ve been charged with looting or handling stolen goods; or what homeless, penniless criminals might do to eat; or when I introduce the concept of Sippenhaft or collective punishment practiced under Nazism that is illegal under the Geneva Convention.
 Very often the conversation begins aggressively then moves to a kind of cri de coeur of “But someone should do something!” I have little idea of what can be done if as a nation we are only ever encouraged to pour hatred on a Radical Other but I’m heartened that time after time people welcome the opportunity to be heard, to be authentically responded to and to hear about different ways of seeking possible solutions. Simply knowing that it’s fine not to know has come as a relief to many people.
Because of course there are solutions that move beyond lynching or bringing a looter to live with you but they do involve opening oneself to some difficult and complex realities. Behaving like a deranged 1950’s headmaster may well appeal to some people who will never riot but vitally alienates and ignores people who feel they are hated by the rest of the population.
And they’re correct, they are hated and the realities that create their lived experience are ignored. People living in poverty seem to exist to be hated as centuries of Poor Law suggest but more than poverty on its own it is inequality that results in rioting. 1 That arch-conservative columnist, Charles Moore recently wrote an extraordinary piece entitled “I’m Starting To Think the Left Might Actually Be Right” 2 addressing Britain’s gross inequalities.  The Resolution Foundation confirm his view:
‘ The share of national income going to the bottom half of earners in Britain has fallen dramatically over the last 30 years…..These ordinary workers have seen their share of GDP fall by a quarter, at the same time as the share going to the top 1% of earners increased by half.’ 3
 One in five of the British population lives in poverty along with 2.6 children. Only 5% of the UK benefits budget supports workless, working age adults  4 and London is the most unequal city in the developed world where the richest tenth have 273 times the wealth of the poorest tenth. 5
20% of the British adult population is functionally illiterate and a third of us can’t add up two 3-figure numbers. 70% of children permanently excluded from schools have difficulties with basic literacy as do 60% of the prison population. 6
If we don’t want further riots we may want to consider our response to these issues. Counsellors are part of the wider world and part of the nation in which we live: as such we’ll share healthily diverse political opinions parts of which will verge towards pulling oneself up by the bootlaces and parts of which will acknowledge that you have to have bootlaces of some description to start with whether that’s the ability to read or a safe home. Counsellors, like every other person in society, have a responsibility towards that society and we also have the huge benefit of being taught to think, taught ways in which to listen when people are distressed and saying things that they might not actually believe, and taught to create an environment in which a person feels safe enough to move beyond cliché towards exploring their genuine beliefs. Perhaps more than any other profession we have been schooled in the transformative art of empathy, something that seems shockingly lacking in recent days.
Imagine that you have been told that you can make it if you simply try hard enough and you still fail. You’ve been told you can become a millionaire if you follow your dream but the dream has withered. You’ve been told that you will be given respect and status if you wear a certain brand but you know you’ll never be able to legally afford any of it. Imagine working wretched hours at a job you hate then seeing young criminals living a life you were promised.  Imagine how you might feel when new communities are introduced to your old established neighbourhood, and that people who will never set foot in these communities contemptuously dismiss you as racist and backward for not wholeheartedly embracing something you know nothing about. Imagine knowing that your 10-year-old son must soon begin to accept being stopped and searched on the basis of who he is. Imagine what it must be like to be ignored all the times you’ve peacefully demonstrated against the endless reports of deaths in custody, but the attention of the worlds’ media is focused on 50 people from your community who go looting. Imagine being told by that you are going to kept safe and the mobile phone network shut down if rioting begins again then seeing that your streets are just as dangerous and that it’s technologically impossible to block all mobile signals.
Imagine that your voice seems to’ve been heard when you demand that looters be evicted from their social housing and then other voices talking about complex things that have nothing to do with you drown you out. I’m heartened and not a little relieved that sensible, careful analysis has already begun but it’s quite clear that it’s accompanied by a snarling retreat from people we might be tempted to call cynical but who may actually feel defeated.
Counselling is notoriously middle class, very few of us will have meaningful experience of living as part of communities who experience shocking generational deprivation, impoverishment or illiteracy, most of us will have no concept of what it is to live this way as a matter of course. People of all backgrounds who live in these communities are begging to be heard, as are solid, relatively prosperous people who feel dismissed as badly educated working class thugs. We know that when people feel unheard they very often shout louder: counsellors are members of a very small group who, with no other agenda, are able to listen and hear. It may seem very little in the great scheme of things but it seems to me to be particularly necessary now. How counsellors make themselves available to disenfranchised groups might be part of an important discourse for our profession.
1. Abbink, A., Masclet, D., Mirza, D. 2010. Inequality and Riots – Experimental Evidence Research. Association Francaise d’Economie Experimentail  Paper 2010 -13
Barro, R.J., 2000. Inequality and Growth in a Panel of Countries. Journal of Economic Growth. 
2. Moore, C., 2011. I’m Starting To Think the Left Might Actually Be Right. Daily Telegraph. 22 July
3. Whittaker, M., Savage, L., 2011. Missing Out.  Resolution Foundation. Available at: [Accessed July 2011]
4. Department of Work and Pensions. 2011. Households Below Average Income (HBAI). Available at:
5. Dorling, D., 2010. Injustice: Why Social Inequality Persists. Policy Press.
6. Clarke, C., Dugdale, G., 2008. Literacy Changes Lives: The role of literacy in offending behaviour. National Literacy Trust.

Post Riot Musing 1

I don't know what to say about the past week of riots and looting but, like the rest of the nation, I'm a bit knackered by it all. There's a great deal to be said about it beyond lynch mobs and posturing, not least on the vital, fundamental importance now of empathy. Empathy for everyone, including David Starkey and for the young people who have been yelling about their situation for some time.

But since this is a blog about class and income in relation to counselling I'd like to share two things with you.

The first is a blog from the LSE which demonstrates how cuts and social unrest are intimately linked.

The second is the only response I can find after a long search for counsellors thoughts on the subject.

Thursday, 28 July 2011

The Inequality Gap

 From the RSA blog   Matthew Taylor

When doyen of conservative columnists Charles Moore writes a column entitled ‘I’m starting the think the Left might actually be right’ it’s time to sit up and take notice. His article contains this paragraph:

‘ The rich run a global system that allows them to accumulate capital and pay the lowest possible price for labour. The freedom that results applies only to them. The many simply have to work harder, in conditions that grow ever more insecure, to enrich the few. Democratic politics, which purports to enrich the many, is actually in the pocket of those bankers, media barons and other moguls who run and own everything.’

Moore’s analysis is confirmed by a report published today but the excellent Resolution Foundation. The report’s headline finding is this:

‘ The share of national income going to the bottom half of earners in Britain has fallen dramatically over the last 30 years…..These ordinary workers have seen their share of GDP fall by a quarter, at the same time as the share going to the top 1% of earners increased by half.’
Not only does gross inequality seem endemic to modern ‘free market’ capitalism but from the work of Picket and Wilkinson and others it seems at least very likely that among rich countries more unequal societies are also more unhappy societies with greater social problems.

Friday, 22 July 2011

Failing Before School

The clear links between early child development and later adult outcomes do not bode well for children of the poorest families, who, as new research has shown, are much more likely to exhibit clinically relevant social and emotional problems than their wealthier peers, writes Yvonne Kelly.

From the LSE Blog

Tuesday, 5 July 2011

A Real Human Being

What a strange day yesterday was.  A dear friend of mine came round, someone who is entirely trustworthy and straightforward, a person who has over the years become friends with his GP and barber and house sits for them and their friends from time to time.

My friend, lets call him Jonathan, brought round some vegetables that a one-time employer of his had been unable to sell and needed to get shot of. Jonathon doesn’t like courgettes or lettuce all that much so he brought them to me. We sat, enthusing about how our small networks function, how kind people can be and the basic generosity of the world. We drank elderflower cordial that I’d made from the late spring abundance of the wasteland up the road enjoying the warm feeling of relaxation, company and having enough.

In fact, Jonathon doesn’t have enough and never has. He lives from dole cheque to dole cheque with small bits of occasional cash in hand work on the side, around £30 a month. He has kept it together sufficiently so that he doesn’t have to pay the highest possible utility charges by being on the wretched pay-as-you-go gas and electricity and his standing orders consume his entire – his entire – dole payments. Which is to say that he has no money for food.

Once every 7 years or so he’ll pack up his minute council bedsit saying that he just knows someone will want to exchange this time and if he prepares for it, offering change no resistance, then it’s all the more likely. When he unpacks he rationalises his lack of movement to something entirely reasonable: Christmas being so close that no one wants to move, or the school holidays or an economic downturn or upturn. Yesterday we spoke about this phenomenon again and I believe I saw the first small cracks in Jonathon’s’ belief. 

He’s nearing 60 now and has been waiting 40 years for an exchange. Jonathon has never been to a counsellor; he’s never felt the need for one. His way of being in the world has always been positive and optimistic and I have no sense of him wanting or needing to explore his life in the kind of depth that many counsellors work with. There’s no searching for meaning, he’s logical and charitable when differences between him and others happen – which is by no means often – he’s busy, productive and talented. What’s more he follows his talent and produces very beautiful paintings which, like so many artists, he finds he just can’t bring himself to sell.

To all intents and purposes, Jonathon is a terrible failure. He’s not married and has no children. He sponges off the state as a lifestyle choice as well as defrauding it and lives in a fantasy world while freeloading off his friends. And I love him and so do his other friends who respect his way of being as authentic and valuable. Jonathon isn’t some winsome halfwit, he speaks several languages, can turn his hand to most practical jobs and his mind to philosophical problems. But he just can’t do the 9 – 5 or sit in a packed train for 2 hours a day or phone people up out of the blue to try and sell them something they don’t want and be resilient to being endlessly told to fuck off. He’s a fully functioning human being, one of the few I know, and because of that he can’t do the same meaningless thing, endlessly.

Yesterday afternoon, perhaps I saw Jonathon look to the future. To be sure, it’s grim for the majority of us whether we’ve paid into a pension or not, and Jonathon won’t be able to escape the possibility of losing his very meager and therefore very precious possessions to submit to the terrible endurance that is an old peoples home.

I believe I saw Jonathon just begin to give up on a dream and face, very briefly, the possibility of an old age eating dog food and sitting in the dark. We’ve known people for whom this has been an absolute reality, people who had no family, whose support networks had also grown old and moved or died.

What do I want to say to Jonathon? Nothing, really. He is well past being able to do a nice little part time job; though he can work regularly and well routine is death to him. He’s old and wise enough to look some sweet 35 year old coach/mentor/advisor in the eye and wonder why she needs to be so driven, and possibly remind her of her own dreams of authenticity, lost to presumed material need and status anxiety.

Richard Carr Gomm walked across Europe at the end of WW2 and came to live in London where he saw his elderly neighbours in need and helped them out. In time, four of them moved in together and Richard looked after them. He repeated this with a number of other elderly people, setting them up with housekeepers and creating the Carr Gomm charity. 50+ years on they’re now very well organized and professional. Amongst other things
We also offer opportunities for people to improve their fitness and diet.
Which is nice.

The impulse to offer un-CRB checked, unprofessional, un-audited, unregulated and heartfelt attention to people as they are rather than as we think they should be is what begins the journey of caring for others. Jonathon has always offered people, has always offered me, that. I hope we can continue to reciprocate.

* Identifying details have been changed.

Tuesday, 14 June 2011

Don't worry, it's only an unemployed person who was killed.

Charles Bunyasi, a public service worker who needed another job to pay the bills, was horribly killed when his delivery van was stolen and driven into him. He suffered terrible head injuries and was left for dead. The language used by the police and media demonstrate just how far we've come in demonising the unemployed.

Detective Chief Inspector Cliff Lyons said:
"Charles was an honest man making an honest living. "He was a working man who had two jobs to supplement his income and to support his family. It is a tragedy."

Remember the women who were killed by Peter Sutcliffe? Some were prostitutes. Those that weren't prostitutes were 'innocent.' This language was repeated during the Ipswich murders.

On my way to work this morning, two men were chatting at the bus stop, reading the coverage of the Ipswich case. "My sister lives in Ipswich," said one. "Yeah, but don't worry - he's only doing tarts," came the reply.

It's hard to avoid the hard wired and sanctioned misogyny in almost every area of public life. And racism. And now - what shall we call it? otiosaeism? Let's just call it what it is - the sanctioned hatred of the unemployed.

Poor Mr Bunyasi, and his family. His life was precious, whatever his employment status.

Sunday, 12 June 2011

Sharing the Pain: The emotional politics of austerity

A degree of paranoia clearly motivated the very production of the poster in the first place, intended as it was for use only in a moment of national defeat, the very possibility of which more optimistic minds would have refused to countenance. But the imagined scene which it conjures up is simply infused with paranoia on every level: an invaded people maintains its stoicism even while surrounded by the forces of an advancing, potentially victorious enemy. Just think what is really implied in this imaginary scenario: a national community is sustained in the face of its possible destruction only by a wilful denial of the reality of its defeat, carrying on as if nothing has changed, as if to admit to the reality of the situation and to respond with appropriate emotion were to invite destruction.
Jeremy Gilbert,

Wednesday, 1 June 2011

Evidence Based Practice

I don’t know whether it’s worth writing this piece.

This is the week when yet another report is churned out about how awful nursing care for the elderly is, an occurrence so regular that there’s no shock value to it any more. It’s the week in which PC Harwood is being charged with manslaughter two years after he was seen to belt a man who was walking away from him, and the week in which the Met cleared officers of any wrongdoing after they tipped a protestor out of his wheelchair and dragged him across the road “ . . . in his own interests.” 

It’s the week in which the abuses at a home for people with learning disabilities has finally been brought to light and the week in which the BACP has printed a three-page article in the guise of a letter denouncing the ‘wilding’ of psychotherapy as proposed by Nick Totten the previous month. Using words like ‘chaos,’ ‘unfounded,’ ‘unresearched,’ ‘mass destruction,’; so thoroughly demonstrating a complete lack of awareness – let alone understanding - of systems theory or even of basic  archaeological propositions while critiquing them without references; and coming too close to calling tribal people primitive exploitative slave keeping savages in comparison to the peaceful Utopia that we ordered, civilised people live in that the purpose for its publication is baffling, to me at any rate.

What links the first 3 events is that they are are massively regulated. It’s illegal to impersonate a nurse or a police officer. Police officers and nurses go through rigorous training and have to attend professional development events to maintain their registration. 

“Regulate, inspect and review all adult social care services in the public, private and voluntary sectors in England.”
are paid for with public money, is staffed by professionals who have passed many exams and who ignored what vulnerable people told them.

Regulation, registration, post-training education, writing essays, being in the job for many years, being valued with a publicly paid wage and being employed by a service that is respected and valued and as mainstream as it's possible to be is no guarentee of good practice.

This is also the week when a respectable, successful, accredited psychotherapist attached to GP’s surgeries was sanctioned by the BACP because an undercover reporter blew her cover. Not an ordinary client, not a GP, not her peers – and hey, she passed the Accreditation process, having
“ . . . achieved a substantial level of training and experience approved by the Association.”
which, despite its emphasis on inclusivity, totally missed the fact that she is a homophobic nightmare.

(It's worth noting the beurocratic/shambolic BACP response to the complaint:
"Without being well educated and having free legal help to interpret the BACP's jargon-dense literature and legal letters, I would have found the process incomprehensible and intimidating.")
I’m not sure it’s worth writing this piece because I’ve come to believe, more strongly than ever before, that psychotherapy and psychotherapists are just part of the problem, the problem being institutionalised fear and ignorance which leads to banal evil.

Speak with most individual counsellors and the conversation almost always goes along the lines of “Yeah, we know there are too many counsellors being churned out; we know accreditation means nothing other than that a person can tell the BACP what it wants to hear; we know we have to compromise ourselves beyond what we believe is ethical if we want a paid job.” And still, counselling organisations demand their counselling staff be BACP accredited: I can understand non-counselling employers wanting what they’ve been told is the best, but counselling organisations?

Psychotherapy and counselling are based on philosophical understandings about what it is to be human, fulfilled and unfulfilled, to have a life that has meaning and purpose or otherwise, what it is to be in genuinely therapeutic relationships. Our years of training are spent doing what exactly? Questioning ourselves, questioning our assumptions about the ways the world might be, learning some of the foundational beliefs and values – all of them complex and multifaceted – of people like Buber, Gendlin, Freud, Husserl, Satre, Foucault? Presumably this takes some intelligence and the ability to learn. And then what? Do we pass the test and carry on just as before but with a nice bit of paper, an increased sense of personal status and a language that allows us to believe we're capable of independent thought? With all this incredible knowledge, do we begin to wonder if we might choose to think even minutely differently from people who haven't had access to this privilege? Or do we totally succumb to the overculture?

Where are Therapy Today news pieces about the DWP receiving guidelines on how to deal with the increased risk of suicide in some claimants? Or the on going collapse of so much of the voluntary sector that counselling depends on? Or what happens to people who used to access those charities? Or the psychological impact of cuts to public services for users, or workers who are made redundant or who live in fear of redundancy? Or the well researched psychological fallout  of our bottomless pit of inequality? Or the overwhelming emotional changes in the national zeitgeist in an age of austerity? Or that "One in 20, or 340,800, British families live in "severe housing deprivation" – in overcrowded homes in poor condition, without a bath, shower or indoor toilet."

It's much easier to have a nice piece about how the tango is like therapy, to look inward and inward and inward, becoming more and more sterile. Or is it that counselling and psychotherapy actually have no relationship to the world of the client?

Who is asking why there are four times as many CDP pages in Therapy Today than there are jobs, and what that might mean? Who is asking why we do therapy at all, for whom and for what purpose and to what ends? And how are we – you, and you and you and I – demonstrating that?

Who is asking, “Who has the power here? Where does power lie in British psychotherapy and counselling?”

I hear a sound in the distance and fear it’s just an echo.

Tuesday, 31 May 2011

Professionalism Does Not Equal Care or Good Practice.

‘The urge toward professionalism builds up a rigid bureaucracy… Bureaucratic rules become a substitute for sound judgment… the bureaucrat is beginning to dominate the scene.’
Rogers C. A way of being. Boston: Houghton Mifflin; 1980.

Back in the last century when I trained as a nurse we worked full time on the wards as students with 2-week blocks in college. I bloody hated it, it was horrific hard graft, I spent a great deal of my first 6 months confused and at 18 part of me felt mildly outraged that I was mopping floors. I was deeply concerned about my status – me, with excellent A levels, washing old ladies: wasn’t I better than this? It took me some years to learn how important that intimate, thorough, routine act of care was; how vital it was to my understanding of the overall wellbeing of the patient; how it could be a tender and meaningful opportunity to touch and be touched in a world where touch usually involves pain.

When I qualified 3 years later and met some student nurses at the end of their first year I thought they were joking when they told me I’d need to show them how to take a blood pressure.

What had happened was Project 2000, a scheme to professionalise nursing.

The knock-on effect was enormous: care assistants, untrained or semi-trained people who are paid a pittance, took over the bulk of patient care, nurses changed from people intimately involved in and minutely informed about patient wellbeing to university trained academic professionals. There are never ending court cases and a growing debate about patients being neglected, positive cruelty and, if it didn’t happen in a hospital, manslaughter.

My daughter is moving into the world of work and wants to train as a midwife. In a haze of middle-aged nostalgia I got out my first wage packet from 1983 when I earned £65 for 3 weeks work after rent for my room in the nurses home was taken out. My girl is supposed to feel grateful that she doesn’t have to pay in order to become a member of a profession that serves the country, and she’ll have to get a paid job at the same time as training and living at home. But she’ll be a professional.

What’s all this got to do with counselling?

The discourse around the professionalization of counselling in modern times has been going on for at least 20 years and I note that so many of the names cited in this article – Anderson, House, Heron, Pilgrim, Thorne - have inevitably become older and distanced from the shaping of counselling. I note also, and with no satisfaction whatsoever, that everything that this article foresaw has come to pass other than the predicted ‘closed ranks’ of counsellors: instead we’ve atomised into individuals who work in fear of being featured on the back pages of Therapy Today, scrabbling about for a paid job.

There is an ebb and flow in all philosophy and the talking therapies over time have moved from elite private practices to institutionalised medical models, from a deep concern about the humanity of the individual to an objectification of the client as an ‘opportunity’ (as an illustration of the problem, this article which used to be free is now not available while the fee gathering service is being set up. You can find the reference to the independent research on a decades worth of counselling complaints here.)

For me, this is a central issue:

“The client will have access only to privileged, affluent and academically gifted counsellors. Not all clients would choose a counsellor with that general background. The cost of training and the tilting of the balance towards demand exceeding supply will drive counselling prices up - the client will have to pay more for counselling and it will become even less accessible to those on low incomes (House, 1995). The increase in counselling fees will be reflected in increased supervision fees and the combined effect of these increases may be cumulative in successive generations of practice.”

After all these years of debate my 18 year old can still legally set herself up as a counsellor tomorrow. After all the years of hoop jumping and box ticking, status-anxiety and portentous intoning about ‘protecting the public’, we still ignore the fact that clients make hardly any complaints that accreditation was quickly taken up by many counsellors most likely to be abusive and speaks volumes about our delusions of grandeur and fear of our own legitimate power – Protecting The Public From The Omnipotent, Dangerous Counsellor (that’s you, by the way.) Clients aren’t stupid and particularly vulnerable people are cared for by systems that are already massively regulated, and which still continue to fail, depressingly often.

The dynamic between status and money has always been complex. I’d go so far as to propose that in the absence of money, the desire for status becomes acute and we know that counsellors seldom make money from counselling. We are naïve if we don’t see the link between money and care at the most fundamental levels. The US, where the connections between money and care are brutally demonstrated, is now experiencing the extraordinary situation of pioneering practice and research running alongside a system that is moving steadily back into the medieval, as one in five hospitals is run by the very wealthy Catholic church.

Why? Because the system wants to save and to make money and will take it from the highest bidder, no matter their philosophy. In business hard cash comes before life or choice so relatedness and connection come way down the list of prioroties. Our NHS, schools and other public services are inexorably being groomed into this mindset. What would you chose for yourself? Have you made the same choice for the ‘profession’ of counselling?