Reply to Virginia Ironside:
Published in The Times November 22nd 2003
I would concede that Virginia Ironside is an articulate critic of therapy who has never been helped by those she has consulted. Perhaps she could not be. But who ever suggested therapy was a branch of magic? Therapists can’t even promise to make you happy. What we offer is support and insight in the face of confusion. Antidepressant medication, by contrast, which does offer to make you happier, fails to work for up to 30 per cent of all patients although the prescriptions for such medicine have doubled in a decade. Few people would suggest that we should abandon all psychotropic prescribing so why the hostility towards psychotherapy and counselling?
Well the first part of the answer is simple. Much of the target of Ironside and her furious sidekick Professor Furedi is nothing whatever to with accountable, professional therapy. Their true opponent is Oprah. They dislike self-styled, opportunistic, untrained and “self-help” psychobabble. My professional organisation actually agrees with such a criticism. You see, the whole field of psychology, counselling, psychoanalysis and psychotherapy is unregulated by law (except for child therapy). For this, you must blame Tony Blair not us. As a result, there are leading gurus like Carole Caplin who may be mistaken for “therapists” but who have no discernible accreditations with any relevant psychotherapy bodies. And thanks to the legal position, they don’t require qualifications either though “therapy culture” gets the blame for the self-indulgent values they appear to promote.
The second part of the answer is unfortunately the fault of the media. How many times have you heard about “an army of counsellors” descending on this or that scene of tragedy? Either it’s the “9,000 counsellors” at the site of the twin towers from September 11th onwards, or it’s the “swarms” (vile metaphor) at the crash zone of any other major transport disaster. The truth is these soldier bees are NOT counsellors but support workers (like nurses, fire officers and social workers) who are genuinely trying to help but sometimes don’t have much trained expertise. The result is that the “one-off debriefing” they offer has been shown to be less than effective. But for the Sunday Times, at least, last March, this put into question the entire professional reputation of British Counselling and Psychotherapy even though 98 per cent of our 20,000 members have never ever worked at a crash site.
Now for the confession. I too used to be an intellectual anti. I also probably went into this job 20 odd years ago for some of the wrong reasons. But part of the training of any accountable therapist is to receive personal therapy. Of course, this may be regarded with some irritation – “Why do I need this?” Nevertheless it’s necessary to find out what it feels like to sit in the client’s chair across the room. I am very glad I stayed to complete the course.
It changed me by changing my emotional environment. It adjusted my values by holding me to account. My therapist John was a stern figure who was always reliable, perhaps the most reliable male in my life up to that point, but not my friend, more like a catalyst for my not very well developed conscience. He was always focused and always “well” (a vital point – who needs a depressed therapist?). Despite myself and my resolve to “tell him only what he needs to hear”, I found myself using the process properly. I began to make connections. Why did I “love and leave women?” Why was I so interested in sex? Why was commitment a dirty word? Why did I need so much attention when the evidence showed I had a fair range of abilities? What did it mean that at the age of 19 I quoted Richard III (in Henry VIth) with such strong approval: “I have neither pity, love nor fear”. John never told me to do, say or think anything. He always made me do the work (damn him) and establish connections. I came away from the experience with a much greater sense of independence and a resolve to stop behaving as I were autistic when I am not. It even made me punctual.
Today I feel angry that the value of this experience is under attack by those who won’t read the research showing that counselling, for example, is the treatment of choice for most depressions1, and who promote the repressive values of the 1950s. As I recently said to Dr Furedi: If every last counsellor in the land were to be hanged by the entrails of every last psychotherapist, Britain would still remain a post-Imperial power in search of a purpose. And the changes in religious belief, family structure and social mobility since 1950 would still mean that many people were seeking ways of making sense of their situations.
A study summarised in the BMJ on 2nd December 2000 shows that the most effective help for most depressions (ie those lasting less than a year) is COUNSELLING. According to the Department of Health, cognitive therapy is the treatment of choice for eating disorders, phobias as well as for many depressions and obsessive-compulsive disorders – see “EFFECTIVENESS MATTERS” – www.doh.gov.uk/mentalhealth/treatmentguideline/index.htm.