THERAPY BEYOND MODERNITY

This is a crusading and passionate book. Richard House writes as a practising counsellor who has become deeply disenchanted by the forces which are driving counsellors and psychotherapists to establish themselves in professionalized bodies, bound by codes of ethics, and subject to official registration. Far from serving to improve standards and protect the public, House sees these moves as cementing a modernist 'regime of truth' which has little to do with healing, and much to do with pandering to the fears of therapy professionals who are unwilling to acknowledge the chimerical quality of their supposed psychological knowledge and expertise. House argues that, within the straightjacket of analytic thinking, therapist and patient are equally trapped in what can become an abusive regime from which neither can escape – though the imbalance of power means that the therapist can too easily 'diagnose' the problem as belonging to the patient. Given the full-frontal nature of his attack, it might be thought that House belongs to the anti-therapy brigade. Not so: he remains committed to the therapeutic enterprise, but (post-modern style) longs to re-vision therapeutic work along the lines of the new scientific paradigm so that it becomes genuinely relational, intersubjective, and spiritually open to the mystery at the heart of being - the mystery which has long been known to the mystics. (Among his personal favourites are the Indian philosopher, Krishnamurti, and Rudolf Steiner, who appear at key moments in the text). Those familiar with the recent politics of the counselling / psychotherapy world will appreciate that House is battling against a powerful tide. The meat of his argument, (and it is an argument: towards the end of the book he almost ruefully acknowledges that he has chosen to use the tools of [modernist] 'academic rational discourse,' p255), is delivered in three parts. In the first, he seeks to deconstruct the therapeutic 'regime of truth' which causes therapists to understand themselves and their patients through the myopia of their core therapeutic model. This is followed by a critical interrogation of certain key therapeutic concepts and practices. In the second part, he seeks to substantiate these criticisms by relating them to three personal accounts of therapeutic distress published by Rosie Alexander, Ann France, and Anna Sands. In the third part, and more sketchily, he sets out what he calls the framework and resources for a ''post-profession-centred', deconstructive-critical therapy.' Anyone attempting to review this book ought probably to locate themselves on the therapeutic 'map'. I write as a member of the British Association of Psychotherapists, registered with the United Kingdom Council for Psychotherapy and the British Confederation of Psychotherapists. For six years I was a member of the BAP's Ethics Committee, where I spent many hours thinking about codes of ethics and practice. These facts, alone, ought to identify me with the object of Richard House's attack. In fact, I agree with many of his points, not least Groddeck's wonderful statement, that 'man's true profession is to become a human being' (p194), and his quest for an authentic spirituality in which to ground our work. Perhaps my position is atypical, in that I am privileged to work in a spiritual centre which offers a number of approaches to healing including low cost, fixed term counselling and psychotherapy. From my perspective though – and I appreciate the open way House writes, inviting us to join in the struggle for the 'soul' of the therapeutic enterprise – the central problem with his methodology is that he pitches a modernist, privatized but organization minded, scientistic, 'old paradigm' model of psychotherapy against his hopes for a New Paradigm, post modern, inter-personal, co-operative, model. This approach means that he has to spend a lot of time deconstructing crucial aspects of analytic theory while, at the same time, wanting to hold on to key ingredients in traditional analytic thinking (at different moments Bion, Jung, McDougall, Hobson, Smail, Lomas, Fromm and Winnicott are quoted with approval). I am not convinced that this before / after, either / or approach does justice to the complexity of the situation; nor do I think that the core therapeutic concepts which he deconstructs in Part 1 can so easily be dismissed. What seems to me crucial, in therapy, is not just the attitude of mind, but the whole orientation of the therapist towards the mystery of being; and most immediately towards the person they are with. No amount of training can instil the 'therapeutic attitude' where it is lacking - though this is not an argument, to my mind, against the potential value of some training. Equally, I am not opposed to a core psychotherapeutic model (though actually, in the analytic world, there is no one core model, but rather a cluster of related but rationally irreconcilable models). What concerns me, though, is the way in which therapists relate to their core model(s). If, as House is convinced, we are subject to their 'regime of truth', then we are prisoners indeed; but need this always be the case? Models are good toys but poor masters. I know there have been times when I have enacted many aspects of House's catalogue of therapeutic errors – to my patients' detriment, as well as to my own. But there have been other times when I have inhabited the same structures but in a different way and these moments have been mutually life enhancing. A review gives little space to engage with the richness and complexity of this book, but I hope my stumbling thoughts will encourage others to join in the vital debate which Richard House is seeking to promote.