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Published in Self and Society, 36 (2), 2008, pp. 4450
Towards Post-professional Practice:
Principled Non-Compliant Practitionership in a Post-Regulation Era
Over a decade ago now, I wrote an article for Self and Society titled ‘From professionalisation towards a post-therapy era’ (Self and Society, 25 , 1997, pp. 315), in which I partly advocated and partly predicted the dawning of a new era in human-potential, therapy practice which I labelled as ‘post-professional’, and which I believed to be fully in keeping with the core humanistic values which I and other readers of this journal strive to uphold in our work. Part of this process, I hoped-predicted, would be the gradual ‘paradigmatic’ movement beyond quasi-medical-model ‘psychotherapy-mindedness’, and towards a form of helping which was, following Ivan Illich, ‘post-professional’ in the sense developed at length in my subsequent book Therapy Beyond Modernity (Karnac, 2003). Little did I know at the time of writing that article that the forces of ‘modernity’ would re-assert themselves in quite such devastating fashion under New Labour’s political reign, with the accompanying super-saturation of modern culture by managerialist, ‘audit culture’ values. Some commentators had indeed predicted that the thrashing around of modernity’s tail during its death throes would be very marked but few of us realised just how fierce it would be; a theme to which I return below.
Now, over ten years later, the form that therapy professionalisation has taken has continued to evolve or should that be degenerate depending on your viewpoint. All of my colleagues who have campaigned assiduously against the state and statutory regulation of the psychological therapies (see Further Reading section), and now at least some of those who have erstwhile (and often equally assiduously) campaigned for regulation, have been appalled by the prospect of our field being state regulated under the auspices of the Health Professions Council. And our angst is merely compounded by the extraordinary news that broadly defined humanistic work seems to be under severe threat in the incongruously termed ‘NICE’ new age of CBT-cultivated ‘happiness’. A central question therefore becomes what humanistic and allied practitioners are to do in the face of these oft-seeming inexorable cultural forces to which we seem to be subject.
Perhaps I should say a bit more about my own take on those forces, before suggesting what a principled humanistic response to them might look like. First, there is the way in which how things appear now dominates over substance and authenticity in modern public life surely one of the most pernicious cultural developments in recent times, and one which is doing untold damage in all manner of ways. Then there is the not unrelated ‘audit culture’ and the associated ‘low-trust’ society, together with a pervasive post 9/11cultural anxiety which is presumably a major factor in these developments. The managerialist ‘audit culture’, and its accompanying disciplining and infantilising procedures, is saturating every aspect of public life and, increasingly, the private sphere as well; and the field of therapy and counselling is by no means immune from these developments. In the current fashionable and largely uncritical obsession with ‘evidence-based practice’ and research, for example, what should be most in question i.e. the culturally constructed and historically specific notion of ‘research’ and its accompanying dynamics, and questions about what might legitimately or meaningfully count as ‘evidence’ is simply taken for granted and assumed to be unproblematic.
Since the late 1990s, I and others have been pursuing a relentless campaign against the audit culture in both the education and therapy worlds, drawing on the kinds of penetrating critiques set out in Mick Power’s seminal 1990s texts. Although at long last there are welcome harbingers of the audit culture and its control-obsessed ideology beginning to come apart at the seams (with mounting numbers of press reports discovering that it is routinely bringing about the very opposite of its professed intention), all that is best in pluralistic human potential praxis is still under grave threat of submergence by the backwash generated by the thrashing about of modernity’s audit culture in its terminal death throes.
Moreover, I find it both surprising and concerning that a forensically critical deconstructive sensibility has not systematically examined the manifold ways in which the audit mentality, with its crass modernist assumptions, has been infecting the therapy world in all kinds of insidious ways not least through the CBT/happiness agenda and the highly contestable ‘outcomes’ claims that have been made for the superiority of CBT-type approaches over other modalities. My IPN colleague Denis Postle has written eloquently about a kind of ‘trance induction’ involved in the seemingly inexorable move towards the state regulation of the psychological therapies; and a similar kind of volition-emasculating process has arguably been active in the case of the audit culture within the therapy world, with practitioners who are eminently critically minded in other contexts seemingly taking the notions of ‘research’ and ‘evidence-based practice’ as unproblematic givens.
My central point is that this pernicious Zeitgeist is one which is quite antithetical to the core values of therapeutic human potential work at its best. In the therapy field, issues of accreditation, state regulation and ‘professionalisation’ have played an ever-more prominent role since the early 1990s. I have tried elsewhere to begin the task of outlining just what a progressive ‘post-professional’ human-potential (‘therapy’) practice entails and might look like; and at least some of the virtues it would embody include those of innovation, diversity, pluralism and responsible self-regulation. These are surely questions that are intensely and unavoidably political in nature, and which deserve urgent and concerted attention from all of us: staying neutral and disinterested in the face of the managerialist colonisation of the consulting room is no longer an option for, as the old cliché goes, not to take up a position on this is to take up a position. .
I believe that the audit culture, and its accompanying mentality and practices, inevitably have a quite deadly effect upon the delicate, subtle soul-qualities which give therapy practice at its best its uniquely distinctive characteristics features that a materialistic ‘modernity’ with its regulation- and credential-mindedness is placing under great threat, as an ‘over-professionalised’ psychotherapy and counselling practice seems destined uncritically to embrace these toxic cultural forces.
One pressing task, which has already been started by people like Mick Power, Andrew Cooper, Denis Postle and Guy Gladstone, is to tease out and name the insidious process in modern culture that leads us, quite unwittingly, to ‘think like a state’ (following James Scott) with all of the deadly sequelae stemming from that mentality. Might it be the case, for example, that we are all in some sense infantilised by the state, and haven’t yet found a mature place to take up in relation to overweening state-driven intrusion into human experience? And might this be especially so in the post 9/11 milieu of acute, unprocessed anxiety, which may well have triggered off all manner of unconscious phantasies? Such a process would certainly account for the kind of paralysing ‘trance induction’ referred to earlier, such that we have been unwittingly drawn into unconsciously relinquishing our capacity for self-efficacy and self-determination to a polity only too eager to project its own disowned anxieties on to us, and then step in with an inevitably ill-fated attempt to assuage them.
These are surely the kinds of questions that critically and politically engaged therapeutic thinking is best placed to engage in; and to the extent that we don’t do it individually and collectively, failing to take a stance and stand of principled and informed resistance and non-co-operation in relation to these forces, the therapy field is most surely in for very big trouble indeed and we will surely deserve all we get.
We assuredly know by now that virtually all technocratic intrusions into human systems generate all manner of typically unconscious dynamics around power, precipitating in turn quite unpredictable side-effects which commonly do more net harm than did the pre-existing shortcomings that the interventions were supposed to address… those intent on state-regulating the therapy world, please take note. And ‘credentialisation’, accreditation and the statutory regulation of an over-professionalised practice are merely further instances of this ‘audit and control’ mentality.
More specifically, crassly technocratic conceptions of evaluation are surely a singularly inappropriate means of evaluating efficacy in the peculiarly unique and idiosyncratic field of personal growth and therapeutic help. What critical humanistic practitioners and readers of this journal should surely be embracing is the most cutting-edge radical thinking in associated fields, rather than uncritically mimicking and colluding with the worst features of the toxic ‘surveillance culture’.
As the anxiety-saturated audit culture proceeds to penetrate every aspect of public and private life, these are issues that will also surely manifest in the consulting room itself, and with which politically committed and aware practitioners surely cannot fail but to engage with their clients. Moreover, as Richard Mowbray foretellingly posed in the early 1990s, to what extent can we preserve a radical countercultural space in a psychotherapy field which becomes increasingly professionalised and subject to the audit culture’s worst excesses? Some humanistically inclined ‘institutionalisers’ might wish to claim that it is possible to retain their original radicalism and the integrity of our bold humanistic vision within a state-institutionalised and professionalised therapy field; but I have always severely doubted this myself and recent outrageous moves to marginalise humanistic therapy within the state’s Brave New therapy regime only confirms that scepticism.
In the 1970s and 1980s, many counter-cultural radicals came into the therapy field because it offered a creative and fluid ‘subversive space’ in which our most fundamental presuppositions about society and human experience could be thought about and challenged. Over time, some of those radicals have now, Animal Farm like, become part of the New Therapy Establishment; whilst others, like that revered political icon of the Left, Tony Benn, become if anything even more radical, the older they get. Those of us in the latter category end up wondering just what more we can do to ‘rattle and shake’ the New Therapy Establishment out of the institionalised complacency into which we believe it to have been seduced by the trappings of status and power for example, by exposing their effective abandonment of the radical roots from which much innovative therapy and human potential activity has historically sprung.
How, then, might we appeal directly to the radical heart of human potential work in this era of acute cultural anxiety, with the primitive material it seems to plug into, and the reactionary ‘acting out’ it seems to precipitate? Or has the therapy field changed so much, and are the motivations of most practitioners now so different from the radical roots (careerism as opposed to human potential development), that seeking to change the trajectory of the humanistic therapy field is pretty much a waste of energy, and we’d be far better off just continuing to do what we do in an approach of (to coin a phrase) principled non-compliance; and if like-minded people discover and join us, all the better. These are the kinds of unavoidably political questions that radically minded humanistic practitioners are thankfully now asking themselves. We might also be witnessing the beginnings of a concerted engagement by radical humanists with the a spiritually informed, ‘transmodern’ or ‘New Paradigm’ politics, considering in the process the form(s) which the latter might take as we voyage through and beyond the death throes of Late Modernity.
Towards Principled Non-compliant Practitionership
Those of us responsible for the literature challenging therapy professionalisation probably share the view that if rational argumentation were to have been given due weight in the debate, then the argument for the state regulation of the psychological therapies would have sunk without trace a long time ago. Something different is therefore needed in addition to rational argument something akin, perhaps, to ideological and political critique, allied with a relentless exposing of the (power) dynamics driving the audit-driven professionalisation psychodrama.
How could anyone believe that a government that duplicitously misled its populace into an appalling war in (or, better, against) the Middle East, and which is presiding over quite unprecedented curtailments of civil liberties and escalations in 'audit' and society-wide 'surveillance', is remotely capable of listening to, understanding, and finally responding maturely to rational arguments that the therapy institutions have, far too late in the day, been putting about how the Skills for Health agenda, the NHS 'NICE' guidelines and the HPC route to regulation entail values and assumptions that the vast swathe of the therapy modalities simply reject outright?
In my view, the role of the therapist, and her/his institutions, should be to preserve a space of critique of prevailing cultural values for as David Smail and others have cogently pointed out, it is precisely such values and ideologies that have so often damaged the clients who seek help and support for that damage and its sequelae, when they come to us for assistance. Just how authentic can any help I might offer to such clients be, if I have colluded with pernicious cultural forces which it should surely be the place of critically minded psycho-cultural commentators and practitioners fearlessly to deconstruct and problematise?
Perhaps we urgently need, then, to re-affirm and re-found the enduring, perennial quality of human potential practice at its radical best. Practitioners can only surely claim to be offering such an authentic experience to clients if they quite explicitly and self-reflexively undertake to strive for a deep congruence between their face-to-face work with clients and/or groups, and the approach they take to, and the relationship they have with, the cultural Zeitgeist and all its psycho-social machinations and vicissitudes. Of course, as an Independent Practitioners Network (IPN) participant, I would argue that the IPN peer-group process is a most effective and progressive way to enable such a congruence; not that it can ever be guaranteed, of course, for to claim that would be merely to mimic the worst modernist excesses of didactic professionalisation. But explicitly to aspire to 'Authentic Human Potential Practice', and all that that striving entails, seems to me to be a useful starting-point for driving a clear taxonomic wedge between those practitioners who really take a congruent selfsociety dialectic seriously as a core aspect of their work, and those who play fast and loose with the politics of the profession as if engaging in the black arts of spin, power-driven manipulation and political inauthenticity had no relation whatsoever with, and could be neatly separated off from, the actual coal-face work we do with our clients.
The policy-makers, state regulators and apologists for therapy institutionalisation seem quite unable to grasp the post-modern subtleties and nuances of our work or else are determined willfully to ignore them. There is certainly a pressing need for the therapy world to deconstruct and lay bear the erroneous assumptions of the 'roles and competencies' ideology, and how, again, its imposition upon therapy practice will do our work a peculiarly excruciating kind of violence. The same goes for the 'NICE' guidelines, and their ignorant and quite unwarranted promulgation of CBT as the favoured, 'empirically validated' 'treatment' in so many realms.
The new, recently launched petition challenging state regulation has in just a few weeks attracted over a thousand signatories, including such notables as Professors Chris Beaumont, Bernard Burgoyne, David Ingleby, Darian Leader, Ian Parker, Andrew Samuels, Diana Shmukler, Martin Stanton, and Brian Thorne, and Paul Atkinson, Dina Glouberman, Paul Gordon, Christopher Hauke, John Heaton, Martin Jelfs, Haya Oakley and John Rowan (see http://www.petitiononline.com/statereg/petition.html).
When the tentacles of the so-called ‘Surveillance Society’ (or SS) begin to reach into the ‘mental health’ realm and into the consulting room itself, we should all realise that we are in very big trouble indeed. I maintain that, notwithstanding the fashionable cynicism engulfing our anxiety-ridden culture, the kind of healthy diversity and innovative richness to which humanistic therapy and the human potential movement still hopefully aspire can only be safeguarded and advanced by a principled non-compliance with the audit culture’s misguided attempts to colonise the consulting room. And it might well be in the signing of petitions, resigning from our institutional registering bodies and (for example) joining IPN, and our continuing to practise as we have done in the face of whatever state legislation is enacted, that we will succeed in protecting the infinitely precious counter-cultural space whose thriving existence becomes all the more urgent in the face of forces which would arrogantly do away with it.
Cooper, Andrew, ‘The state of mind we’re in: social anxiety, governance and the audit society’, Psychoanalytic Studies, 3 (3-4), 2001, pp. 349362
House, Richard and Loewenthal, Del (eds) Against and For CBT:Towards a Constructive Dialogue?, PCCS Books, Ross-on-Wye, 2008 (in press, 2008)
House, Richard and Totton, Nick (eds) Implausible Professions: Arguments for Pluralism and Autonomy in Psychotherapy and Counselling, PCCS Books, Ross-on-Wye, 1997
Mowbray, Richard The Case Against Psychotherapy Registration: A Conservation Issue for the Human Potential Movement, Trans Marginal Press, London, 1995
Pilgrim, David ‘Reading happiness: CBT and the Layard thesis’, European Journal of Psychotherapy and Counselling, 10 (3), 2008, pp. 24760.
Postle, Denis Regulating the Psychological Therapies: From Taxonomy to Taxidermy, PCCS Books, Ross-on-Wye, 2007
Dr Richard House is Senior Lecturer in Psychotherapy and Counselling at Roehampton University, a trained Steiner teacher, and a founder-participant of the Independent Practitioners Network, being a member of the ‘Leonard Piper’ IPN practitioner group. He is deliberately unregistered, and is centrally involved in the ‘Open EYE’ Campaign for Open Early Years Learning.