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UKCP AGM March 2008

Report by Ian Parker

This report reviews and locates the debates at the UKCP AGM in the wider context of dynamic and analytic work under threat from state regulation. (This account does, then, rehearse some long-standing debates with which readers might already be familiar and then describes some specific issues that emerge from the meeting.)

The United Kingdom Council for Psychotherapy (UKCP) conference and AGM in Buxton (14-16 March 2008) was occasion for what were declared, as is often the case in such meetings, to be 'historic decisions'. And, once again, these turning points - around which the organisation seems to revolve and revel in - were questions of internal reorganisation rather than questions of strategy in the face of impending state regulation of psychotherapy through the Health Professions Council. The culmination of a series of sometimes acrimonious debates came on the Sunday morning when delegates were asked to vote on a new 'shape' for UKCP. For a moment, when an amendment to a subsection of a motion that noted that the shape of the organisation needed to change sought to replace the word 'shape' with 'approach', it seemed as if attention might be directed to the outside world. Things returned to normal when the amendment was defeated, and they were back on task to vote on what was marked in the papers circulated in advance of the meeting as 'Shape X'.

The discussions and workshops on Friday and Saturday had explored a variety of different shapes that were condensed into two main contenders 'Shape 2' and 'Shape 6'. Shape 2 would have broken UKCP into separate 'Colleges', among which the 'Council for Psychoanalysis and Jungian Analysis' (CPJA) would have been a sizeable instance, and this college would have then been able to organise itself autonomously (and call upon as-yet unspent funds that had been accumulated in a UKCP levy on delegates the previous year). The nascent CPJA brings together a varied collection of psychodynamic psychotherapists, psychoanalytic psychotherapists, psychoanalysts and Jungian analysts. The descriptive labels for the psychodynamic psychotherapists and psychoanalytic psychotherapists are important to the identity and job security of many practitioners working inside the National Health Service, and the 'psychoanalysis' and 'Jungian analysis' in the college name is the broadest and highest level umbrella term to cover the approaches that all inside draw upon. The 'Shape 2' would thus also serve to reinforce the separation of the old psychodynamic and psychoanalytic section from UKCP-central and the launch of a new organisation that would include Jungians and Freudians in an inclusive non-sectarian registration body that would then be able to stake its ground in relation to other bodies claiming to speak for psychoanalysis.

Such an organisation is fairly crucial at the moment for those practitioners who are refused recognition by the British Psychoanalytic Council (BPC), and especially so for psychoanalysts who have not been trained under the auspices of the British Psychoanalytical Society (BPAS) or one of its sister organisations of the International Psychoanalytical Association (IPA) in other parts of the world. The BPAS is at the core of the BPC and, in alliance with the Jungian Society of Analytical Psychology (SAP), clusters together a number of psychoanalytic and psychotherapeutic training organisations that are willing to abstain from using the title 'psychoanalyst' in return for patronage from their betters (many of whom have functioned as training analysts for those who inhabit the lesser groups). Most psychoanalysts outside the UK are nowadays also outside the IPA, but this is a threatening state of affairs for the BPAS as the local franchise, and it has used the BPC as its own registration body to pretend that psychoanalysis outside its control does not really exist. The BPC is the latest incarnation of a BPAS-led coalition that left the UKCP in the 1990s after its proposal that it should function as a kind of 'security council' upper tier of the organisation was voted down, and it has then pulled the shutters down against the rest of the world.

It is true that the BPAS runs, through the Institute of Psychoanalysis in London, the longest running psychoanalytic training, and that many of the most well-known psychoanalysts in Britain have been members. This, along with personal and professional connections with members of the Royal College of Psychiatry and the House of Lords, has enabled it to avoid too-close scrutiny by government regulators. Perhaps now, their hope is that these connections will allow it to strike a deal in which the title 'psychoanalyst' will be owned by it alone when psychotherapists are regulated by the HPC. There are understandable concerns on the part of UKCP-registered psychotherapists that even 'psychoanalytic psychotherapist' and 'psychodynamic psychotherapist' will be seized by the BPC and so criteria for their use controlled by a partisan and hostile force operating inside the HPC. Membership of the Department of Health 'Skills of Health' project to determine National Occupational Standards for the psychological therapies (with the reference group headed by Lord Alderdice and the strategy group by Peter Fonagy, both figures linked to the BPAS) bodes ill for the UKCP psychoanalytic practitioners.

It should be said that there is a paradox here, which is that the BPAS (along with its dependent satellite organisations in the BPC) has been avidly pursuing legitimation for its work through empirical psychological studies of child development, functional Magnetic Resonance Imaging technology and Randomised Controlled Trials. The hope is that this research will satisfy the thirst of government regulators and 'scientific' psychologists for 'evidence'. Last year's 'Savoy Conference' on 'The Psychological Therapies in the NHS: Science, Practice and Policy', for example, was designed to reassure evaluators that some form of psychoanalytic work might be compatible with the project 'Improving Access to Psychological Therapies' inspired by the Layard Report which lavished praise on (a cheap quick version of) Cognitive-Behavioural Therapy. At the Savoy Conference BPAS member Peter Fonagy, who has led the push toward an evidence-based psychological alternative to speculations about the unconscious, was reported as saying that he will sue the next person who says he is not a psychoanalyst (and Michael Rawlins, Chair of the National Institute for Health and Clinical Excellence, shouted at dissenters in the hall 'you've just been given the biggest pot of money, so shut up and stop whinging').

The paradox, then, which should be voiced at the risk of provoking Fonagy, is that it is psychoanalytic practice outside the BPAS that has remained steadfast in its opposition to fake-scientific promises to end what the IPA in its publications around the world bewails as 'the crisis in psychoanalysis'. It is in the traditions of practice that thrive in the training organisations that comprise the CPJA, for example, that there is healthy suspicion of cognitive-behavioural and neuro-psychological pretenders to an understanding and treatment of the unconscious. While there many psychotherapists inside the UKCP (and the BPC) who welcome state regulation through the HPC, it has been from within the CPJA that objections to the HPC have been most vociferous, and these therapists know that state regulation is antithetical to psychoanalysis. The existence of the CPJA as a more open registration body therefore brings into the public sphere the painful fact that the BPAS is effectively a provincial closed shop.

So, 'Shape 2' looked like quite a good bet for the CPJA that has developed inside the UKCP. The problem was that the practice of psychotherapy is under threat from two directions. State regulation through the HPC will press in on psychoanalytic practice, implementing 'accountability' and 'transparency' in a field of work that gives space for an exploration of subjectivity that questions, in the strange space of the consulting room, 'accountability' to standards and ideals, and cannot ever be said to be 'transparent'. Accountability and transparency are motifs that, if imposed on psychoanalytic practice, will sabotage every form of talking cure and, as is already patently the case in the HPC requirements for training and 'Continuing Professional Development', these motifs will already distort the process by which a practitioner undergoes apprenticeship and their own personal analysis. There are therefore quite specific psychoanalytic reasons why state regulation should be opposed.

At the same time, in a threat from another direction, the government has made it clear that the regulatory process entails a series of judgements about what will count as psychotherapy, and who will be recognised as a psychotherapist inside the NHS. Here, the psychodynamic and psychoanalytic therapists are on stronger ground (in some sense, the NHS is their home ground, and it is in the NHS that they will feel most directly and immediately the consequences of the HPC), and so, while psychoanalysis as such is under pressure from the 'evidence' brigades, the CPJA members could imagine that they were more secure than the 'humanistic' and 'integrative' psychotherapists who are clustered together mainly in the 'HIPS' section of UKCP. In this respect, the BPC registrants could be said to have made a smart move in breaking from UKCP, and from those therapists who might be viewed by the authorities as antiscientific mystics. It is an awkward fact that both Freud and Jung believed in telepathy, and the relationship between mysticism and science is a peculiar one, one that has permitted a number of strange, innovative theories about subjectivity and treatment over the years with which psychoanalysis has had to engage. It has been a necessary and fruitful engagement. This is a time when an alliance with outliers in the psychotherapeutic world is necessary not only for tactical reasons but in order to keep open the space for the future reenergising of psychotherapeutic practice. Shape 2 would have made it very difficult, if not impossible, for those psychotherapists outside the CPJA and HIPS, those outside the two main groups and so on the fringe of the fringe, to survive.

In the event, another shape, 'Shape 6' emerged as the most popular, and it was this 'shape' that was voted on. This shape is problematic, and there are three main reasons why it could have been opposed. The first is that vests authority in the UKCP centrally, even while there are claims that there will be a reorganisation to make the institutional processes more transparent and accountable (and the mapping of this rhetoric on the rhetoric employed by the government regulators is not accidental). The UKCP apparatus has expanded year on year, and it has soaked up increases in fees from organisations and individual members, usually with the call for urgent additional funds for the formation of colleges (the ring-fenced 'college fund', which shape 6 obviates the need for now) or for its ill-fated 'Independent Complaints Organisation' which has been wound up (after opposition to this private company by a number of organisations that refused to be bound by it) on the grounds that the HPC would not allow organisations they brought into the fold to operate any independent complaints procedures. Several psychoanalytic organisations voted against fee increases this year, but a vote against is always liable, of course, to be interpreted as disloyalty.

The second reason why it is problematic is that it accelerates a shift toward individual registration with UKCP rather than through registration via member organisations. It is here also that one of the most enjoyable interventions at the conference was made, by one 'Wesley Tantrum' who accused UKCP of operating as a colonising power, an arm of government in the psychotherapy world. UKCP had opened the Saturday to 'individual registrants', part of the drive to 'enfranchise' the membership, and here was one of them. Wesley was soon outed as Guy Gladstone, a member of the Independent Practitioners Network (IPN) that had always opposed the UKCP collaboration with state regulation and had argued that the 'statutory regulation' promised by UKCP would necessarily turn into something worse over which it would have no control whatsoever. Guy erupted later when he discovered that he was among one of only four individual registrants that had made it into the meeting, and he complained bitterly that UKCP was controlled by training organisations. The UKCP was, at this point, undone by its ploy of turning to the individual and bypassing member organisations on the false premise that is necessarily more democratic, and even Guy was caught in this premise and although he has a more progressive line on regulation than UKCP - that is, he is against it - he could be heard by the meeting as endorsing the turn to individual membership, which is the wrong conclusion to be drawn in these debates. Regulation reiterates the logic of deregulation, neo-liberal specifications of the privatisation of services and the eliciting of individual responsibility. Regulation requires the atomisation of decision-making and the demand to each professional to conform to prescribed standards.

The third problem is that the shift to this shape, to any shape, was being pushed with great speed by the UKCP leadership. Delegates were told on Friday that they should prepare for a seven step programme of reorganisation over the next year to prepare for inevitable HPC regulation, and on Saturday they were told they had twenty-four hours to decide. It is against this backdrop that it was necessary to step back and refuse an agenda that precisely reproduced, unwittingly perhaps but even so, effectively implemented the agenda of the government. Regulation has proceeded in the UK through the production of anxiety and as a materially effective series of demands through which those who participate at any level in organisations like UKCP must spend time and energy describing and justifying what they do or intend to do. Even before the HPC takes over psychotherapy, the impact of regulation has been felt in the urgency and detail of what is required to prepare for regulation, in its most recent ridiculous guise in the 'mock application'. The HPC accepts applications from professions who wish to be regulated, and so now - a sign that it is already too well-behaved - the UKCP itself is preparing a mock application. It should be said that some of those involved are filling this in with some scepticism that this can be done in such a way as to maintain the integrity of their practice, and some CPJA members are participating in the process precisely in order to test the limits of the frameworks presupposed by HPC. Even so, surely to take this seriously is once again to anticipate what the regulators want to do to us and do it to ourselves, to comply with this even before it has come to us as a demand from HPC is to volunteer to be a stooge in a process that many psychotherapists know in their hearts is damaging to their profession and their everyday practice. This sceptical stance is also why some psychoanalytic organisation delegates, including from the Centre for Freudian Analysis and Research (CFAR) and the Guild of Psychotherapists, abstained for the vote on shape 6, but made it clear that they would work with this shape as the best of the options.

The situation is grim, but there are opportunities. UKCP is haemorrhaging about 700 members a year. It was suggested that psychotherapists were very busy people and that direct debits might help keep them in the organisation. CFAR, for example, has only sixteen UKCP-registrants. (The Site for Contemporary Psychoanalysis, Philadelphia Association and Arbours Association were not represented at this meeting.) Some of those members are thinking seriously about not renewing their membership. The frighteners are on; we are told that when the HPC takes over - it is 'inevitable' it is said - the UKCP members will go into HPC at about 65 pounds, but those who then join HPC will need to be 'grand-parented' in at around 470 pounds. What are the opportunities? The CPJA could now become a focus point for an alliance of psychoanalytic practitioners that would bring in those involved in the Consortium and those who are in the College of Psychoanalysts - UK. This inclusion will be regardless of UKCP membership, so at least may bridge some divisions that pulled energies in different directions. The Consortium and College will be invited to the CPJA conference scheduled to take place in January next year, and now we should mobilise inside and outside UKCP to make it a success.

Moves are underway, after a promise from the UKCP Chair that the application would now be a formality, to get for CPJA the descriptive labels of 'psychoanalyst' and also the labels 'psychodynamic psychotherapist' and 'psychoanalytic psychotherapist'. This, it would seem, is one of the quid pro quo arrangements that will resolve a long-standing dispute inside the organisation, and it is in return for the support that the CPJA has shown for HIPS and the other marginalised psychotherapists in the last day of the conference. That support was expressed in a motion, supported by all the CPJA delegates, that the titles of 'psychotherapist' and 'psychotherapeutic counsellor' be adopted as the broadest titles. It was noted that this does not preclude the use of precise descriptive labels, and CPJA will have to move fast to take these labels and to be ready to challenge the BPC should they attempt to use them as titles. CPJA has also prepared a survey which will be distributed and collected via member organisations on the HPC, for and against, and the reasons why in either case. This is risky move, but a sizeable opposition voiced to HPC (which, from a pilot study inside the Guild of Psychotherapists, would seem to be quite sizeable) will help delegates argue for psychoanalysis against the government and against the UKCP attempts to anticipate what government may do it by doing that first, against itself.

Ian Parker (CFAR delegate)