Philosophy Now Forum

Looking back to my thoughts on registration...

I'm bashing away on an essay (it's 5:20am but I think clearest when the world is shut down I reckon!), and I keep coming across the same sort of warning in various texts. All of the big names make a point of mentioning that psychodynamic interventions have the capacity to harm if used unwisely, especially by people not being supervised and in, or with a significant history, of personal therapy. Personal experience testifies to the power of some of these interventions - a well timed interpretation can provide huge insight but there can be a heck of a price to pay processing the insight. I'm thinking of some unresolved grief I chanced upon in myself without warning following some training experiences. The idea is for this to happen as a trainee, better than halfway through a session with a client - through fostering intense periods of personal development and increasing self-awareness. It will still happent that personal issues are stirred up in the actual work but a trained person will recognise what is happening and contain their anxiety until such time as support and debriefing is available. Only through safely accrued experience gained over an intentionally long training period (a few years - you can't rush growth/change), including hundreds of hours of clinical practice, can this experience be obtained. Ongoing supervision is essential to spot when things are going awry (which they are certain to in some way, shape or form) at the earliest opportunity - they can become learning experiences instead of painful messes. Those people who just bypass this whole process, read a library book and print up a card are positively dangerous. Good intentions are not enough.

The more I think about...how has a profession, where, in a sense, you go rooting around in people's minds intentionally hunting out weak spots, gone so long without some regulation? Ok, you will undoubtedly lose some things but it's got to be worth it.

A little knowledge is a dangerous thing...

There are some very screwed up people working in the helping professions, I think they are over-represented for some reason. Perhaps it is a way of getting near to support but not going through the pain it entails? A reaction formation?

Koy, do not get me wrong (I don't think you did), I have no problem with foreigners, and it is indeed the case that a native-speaker who is poor enough in their english would have the same issue.

The foreigner I am speaking of in particular is, I have no doubt, a very intelligent person. However, I found that I would state a sentence and he would grab completely the wrong end of the stick.

I disagree that communication is not everything; it is.
In any encounter with therapy or counselling that I have had I have been frustrated by the seeming impossibility of some things to be conveyed, and for me to express them without recourse to concepts and conceptual movements that seem to bamboozle.

I am not trying to brag when I say this, but I am very intelligent, and I wonder if therapy/counselling can be useful (especially philosophical therapy) if the therapist is significantly less intelligent than the patient.

I also suspect that counselling is unlikely to work if the therapist is significantly younger than the client, because then the counsellor will not be able to grasp the client's perspective.

I think these are both very fair points and I subscribe to both views, although this can be seen as 'rocking the boat'. There is a lower age limit where I am training and I am the second youngest person (at 33). Average is late 40's through to 50's I'd guess. Seeing that I aspire to working in further/higher education settings this should be ok.

The thing about intelligence is part of a broader concept for me - a counsellor is only able to go as far with a client as they can go themselves. This is why personal development is central to the training but I think also if the therapist is getting lost in the client's abstractions then this will be like slamming on the brakes. This is part of the appeal, working in an arena which takes me to the edge of my intellectual capacities on a regular basis.

I guess it is essential that the therapist/counsellor be able to understand the patient and empathise with them, and also essential that the patient have a feel for this being the case.

Even if a young therapist were capable of understanding where an older patient is coming from, if the patient doesn't get the feel that this is the case then it is useless.

A younger therapist can work with an older client perfectly well, indeed if the client is old enough then it is probable that the therapist will be younger, given retirement ages and so forth. Many therapists do some private practice beyond retirement but usually just a few hours here and there.

People often put it down to 'life experience' - an unsatisfyingly vague term but an intuitive one. If you've been around the block and seen a bit of life, had your highs and lows, come out of the other side, been knocked down, got back up, once more round the block, etc, etc, etc. It all congeals into some nebulous resource you can draw from. It can't be taught and can only be accrued one day at a time. Worth remembering though that some people do more living in a year than others do in a decade in some respects. The big questions around mortality, ageing and vulnerability seem very age dependant.

I'm interested in how client's are allocated to counsellors, following assessment by a senior person. Sometimes it makes sense to place like with like (age,gender, outlook) with a view to fostering identification. Other times it makes sense to place people with the sort of person they would wish to avoid - to provide scope for appropriate challenges. For example men who are afraid of women might get more out of working with a female, women living in the long shadow of an overbearing father might work with a male as this promotes transference of old issues into the current moment facilitiating their exploration.

Many people are very uncomfortable with the idea of male counsellor's working with females who have been abused - especially when sexual abuse has been involved. Any benefits in exploring their attitudes to males are overrideen by the risk of retraumatising the client and leaving the client feeling unsupported - the popular idea is that only another woman can really empathise to the requisite degree.

I've discussed this with female friends who agree they would want to only work with a female but can't be clear as to why. One likened it to the idea of male primary school teachers, observing that secretly most women don't want men teaching their little ones but they'll never admit this freely, although all women know where they're coming from.

I thought this was unfair to all of the men who care about children and education but my friend's reaction was, "Maybe it is...but why take the risk?"

Going back to my earlier point - are there degrees of vulnerability when working with people when a cut-off point is reached, beyond which only women are to be trusted to proceed safely? Where does this notion come from? How universal is it?

Why take the risk?
Because there is no risk with men that is larger with women, and reacting to imagined risks takes resources from reacting to real ones.

People seem to dislike gays being involved with children, but gays are no more likely to be paedophiles than straight people.

And it comes from a carefully fostered myth of female innocence, and of the 'wholesomeness' of certain things.

People overlook the wealth of statistical evidence that children are mainly abused by their fathers and that quite often the mothers often know of the abuse and do not report it.

The problem with these stats is that they fall under the "Of those that we catch..." rubric. For example, the stats say that most women will be killed by their partner but many more women are killed than this but we just don't catch the perpetrators. Not that I'm doubting its a problem but if you've read De Sades Bible you would notice that it only takes a few males to get through a large amount of children.
a_uk

After several years of experience in the field I have come to the conclusion that a certain stupidity is the sine qua non of being a therapist.

The therapist, to be motivated in their work, must be blinkered to a truth that confronts them on a daily basis: that what they are doing isn't making a blind bit of difference. We cannot change ourselves at will. We cannot change others at all. Let each therapist make an honest appraisal of their clients and they will find some that imporved some that stayed the same and some that deteriorated. Take an equivalent sample minus the therapy and the outcome would be precisely the same. It is amazing the resistance you meet in the profession to this one robust empirical finding.

The idea that we are somehow in control of ourselves presents us with a glaring humunculus problem that when rationally analysed leads to absurdity. Therapy is a latterday religion predicated on magic, superstition and perceptual error. Therapists themselves are priests who see themselves as able to offer salvation through happiness. Scratch under the surface of any of them and you will find their mind riddled with confusion, but steeped in their own messianic delusions.

Psychonaut

"I am not trying to brag when I say this, but I am very intelligent, and I wonder if therapy/counselling can be useful (especially philosophical therapy) if the therapist is significantly less intelligent than the patient."

Yes this is a problem, as the therapist will suspect that you prefer to intellectualise your life rather than face up to your 'emotions'. The clever patient mind find themselves described as 'unready or 'unwiling to engage therapeutically'. If you are particularly philosophical in nature you might find that yourself deemed liable to 'odd and extravagant abstractions'. Your specualtions on reality might verge on the 'psychotic' and your renunciation of free will suggestive of the 'external locus of control so common in depressives.'

Psychotherapy is a vast and sprawling theoretical domain, all of which is entirely unfalsifiable. Any behaviour whatsoever could be interpreted as being pathological, and in a number of different ways. It is interesting that, in the NHS at least, 'epistemological plurality' is seen as one of the key strengths of the clinical psychologist. Yet the predictive power of these theories is absolutely zero. Their approach to epistemological issues is precisely the same as witch doctors, shamans and astrologers.

Therapy is one of the great illusions of our age. Future generations will look back and wonder at our primitive naivety, just as we do the alchemists and rain dancers. Therapists accept as truth notions that intelligent children reject.

The interesting question then is: why have we fallen into such an obvious delusion?

One part of therapy that I find sad is that when one has a community and a circle of friends, people one can talk things over with and such, then there is no need for therapy.
However, therapy may very well be necessary for the person without the 'social tools' to inculcate such friendships.

Nikolai,
Personally, the interesting question to me is, "How do you morally justify still working in the field if these are your opinions?" Is it that you also think you can do no harm because your services are essentially ineffectual? If so, and you work in the NHS, how can you justify wasting tax-payers money?
a_uk
p.s. Or are you a Psychiatrist commenting upon Psychotherapy?

Hi RA,
This idea that people with mental illness or depression are those that are loners without social skills and friends, appears to deny the facts. As many socially skilled people with large social networks still suffer from such conditions. As is the idea that a 'a cup of tea and nice cosy chat with friends' will solve the problem. A common report from friends and relatives after a suicide is, "Well he was a bit down but seemed to have cheered up after we'd chatted about it", or, "He seemed such a happy well-adjusted person", etc.
a_uk

AUK: My post lacks mention of depression - it also lacks mention of mental illness - intentionally. Perhaps you misunderstood me.