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March17th 2002text
Debate on statutory regulation of psychotherapy in 'The Psychotherapist',
UKCP house magazine

a contribution by textDenis Postle
text text
UKCP's house journal, 'The Psychotherapist', recently included an article by Richard House entitled: 'The statutory regulation of psychotherapy: still time to think again'. A follow up to this in the current issue (late March 2002) prints some letters in response, plus, at House's suggestion, a 'debate' to which IPNOSIS was delighted to contribute. It features six short paragraphs, two from people who are pro-statutory regulation, two who feel neutral about it, and two from people opposed.

Though perhaps overdue, this openness is very welcome. Here is an expanded version of the IPNOSIS 'paragraph'.

The statutory regulation of psychopractice:

creates a religion of priests verified by the state as the only legitimate guardians of the secret knowledge about transference;
The admission to 'qualified' psychopractice too often resembles a process of anointment, especially in the psychoanalytic territories (Young 1999) and of 'schooling' in a 'regime of truth' (House 2002) that over-values what can be taught i.e. sold as a course, and denies the value of more scattered, more accumulative mixes of life experience and self-directed learning which seems more likely to benefit clients.
'Schooling' seems to install a one-legged stool approach to practice that favours 'psychologising' and/or the 'spiritual/transpersonal' to the exclusion of the 'socio/political so that the processes through which institutional power is deployed are rendered invisible, or unimportant. This tends to undermine the courage needed to voice and act from the misgivings many, maybe most, practitioners have about statutory regulation.

creates multiple walled Gardens of Professional Eden;
The extent to which the whole statutory regulation project re-capitulates archaic models of power and authority are well expressed in a cartoon that appeared in the New Yorker a while back. Adam and Eve are disporting themselves in the Garden of Eden, in the heavens, a placard appears saying 'RULE NUMBER ONE: DON'T PISS ME OFF'. As I have pointed out elsewhere, current and recent proposals for statutory regulation will impose a culture of domination on the whole field of psychopractice.
Alongside this, as some of us have found, the walled gardens of registrable psychopractice inhibit or disallow dissent, and inhibit or marginalise 'out-of-the-box' thinking, contributing to a failure of creativity so that colouring in old drawings (The GMC BMC) in new colours (The HPC) is the best that can be envisaged.

institutes discredited quality control - find and bin rejects;
Perhaps because of the decline of manufacturing, few practitioners seem to have enough experience of industry to know that quality control in any remotely efficient manufacturing these days means pro-active quality control of the continuing process. Such modern quality assurance has a feedback loop (or loops) so that drift away from the specified practice leads rapidly to corrective action before rejects are produced. The notion that CPD is adequate to this task seems very naïve.
The essential feedback loop for an adequate practitioner's quality assurance process i.e. one that would fully honour clients interests seems to me to require a high level of ongoing self-disclosure with peers. At the moment the only organization I know of that provides this is IPN.

belongs to the same family of 'security herdangst' as electronically gated and fenced housing developments;
What people who live in such developments near me (how nice for them that they have the 'wild' river close by) seem to fail to notice that from the outside they resemble prisons (I don't exaggerate, inside the walls house after house has lift-gates over the windows) Statutory regulation has long seemed to me some kind of imprisonment. I suppose that, like gated housing developments, it provides a literal guarantee that you only have to relate to BMW, SAAB or Mercedes style peers.
Curious, that in our society many people of the two extremes of privilege and under-privilege, both get to inhabit prisons, except that imprisonment is one of the structural ingredients of cultures of domination.

as currently proposed, extends and deepens the hegemony of the medical model - psychopathology - diagnosis - treatment, and sidelines, or excludes, non-medical approaches that emphasise learning, education and self-directed personal development;
Anyone who had any doubt that this is what is afoot should read the transcript of the talk that Anne Richardson, senior advisor to the department of health gave to IPN last autumn here it is

enables practitioners to avoid the detailed self-disclosure to clients that would enable them to make informed choices;
After watching and trying to resists the glaciation of the field of psychopractice in the UK over the last 12 years, I have come to the conclusion that effective accountability for clients (that they would experience as effective) requires a different approach to those that have been pursued. Developments of this is still embryonic but the two components that seem essential are:
1. The ongoing peer-disclosure that I refer to above presently implemented by IPN and:
2. A comprehensive, public form of disclosure by practitioners of their training, life experience, supervision arrangements, working style, client population (who they don't work with) complaints routing and references i.e. formal statements from people who are prepared to assert that they 'stand by their work'. Entry to this 'full disclosure' model would be open to any practitioner and would be available to clients via an internet database with local client/practitioner/support group initiatives providing paper listings.
Watch this space for further developments.

appeals to the feudal monarch in us;
Just as the 'feudal monarch' lives on in society in the shape of royal families, holy fathers, and houses of lords, so it lives on in us too. We may be inclined to think that the temporal power of such monarchies is so narrowed as to be unimportant and yet they still shape key social agendas, look at the bishops in the house of lords, and the 'establishment' of the church of England. The trouble is that so far as these archaic models of power continue, and thus continue to inhabit us psychically, we may be inclined to think that their power, the domineering tendencies of our inner House of lords, or Royal or Holy families too are similarly so slight as to be unimportant. As so we fail to see that statutory regulation institutes these feudal remnants and the damage that dominance inflicts.
Such a sleep of complacent compliance commits those who are prepared to wear the feudal monarch roles to a poisonous mix of reverence/worship (as an apparently essential continuing bulwark against social disorder) but also fear, (as a source of punishment or retribution for transgression). Either way as in the historical past, it generates victimhood.

enables practitioners to continue to avoid confronting and engaging with issues of political power; and
Yes politics is time-consulting, often tedious, frequently unrewarding, if often means spending time with people with whom you profoundly disagree and yet, isn't some engagement with the exercise of power in its social forms appreciating directly the influence that the exercise of power has on identity and behaviour essential? Isn't this what lots of clients bring to meetings? To work with their power issues? If we take the ostrich option around the organization of our own trade how can we expect that decision not to unhelpfully skew our client work?

invites us to sign up to a culture of domination that mimics that which afflicts many if not most of our clients,
Cultures of domination continue to shape UK government and many, if not all, our social arrangements The statutory regulation of psychopractice asks us to sign up to these damaging cultures despite the evident threading through of daily life of approaches to power that are facing the other way, i.e. child care that is less domineering in style, anti-discrimination initiatives and much greater public awareness of the value of feeling and emotion and so on. The proposals currently out for discussion seem in Canute-like denial of these benign developments, some of them even perhaps the fruits of our labour.

Heron, J., The Politics of Transference: an essay of the AHPP Self & Society Vol.18 No 1, January 1990
article another fundamental critique of the fallacies and deficiencies of professionalisation. So far as I can tell, totally ignored by AHPP.
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Hogan, D., PROTECTION NOT CONTROL Daniel B. Hogan author of The regulation of psychotherapists
from MINDFIELD: Therapy on the Couch Camden Press1999.
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House, R., The statutory regulation of psychotherapy: still time to think again… THE PSYCHOTHERAPIST, 17, 2001, pp. 12-17
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House, R., LIMITS TO PROFESSIONALIZED THERAPY: Critical Deconstructions (Karnac Books, London 2002),
The professionalized therapy form.
Consumer experiences of professionalized therapeutic practice.
A new paradigm, post-professional era?
Whither post-professional therapy?
Conclusion: Who Would Be a Therapist?

'...two broad themes: first, the continuing and deepening challenge to the institutional professionalisation of psychotherapy and counselling; and second, an exploration of empowering, facilitative and diverse solutions to the crisis in which therapy finds itself.'.

Howard, Alex., The place of psychotherapy and counselling in a healthy European social order: further commentary on Tantam and VanDeurzen. European Journal of Psychotherapy, Counselling & Health.
Their hubris and arrogance is outrageous, dangerous. It deserves a passionate and alarmed response....'...Psychotherapy we are told, is 'a new paradigm for living' and will provide 'the replacement of old religious and spiritual values'
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Postle, D., SHRINK-WRAPPING PSYCHOTHERAPY this is a shortened, version of an article based on a talk given at the British Confederation of Psychotherapists Conference 'Statutory Regulation - for or against', June 1999. It appears in the British Journal of Psychotherapy, 16 (3) Spring 2000
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Postle, D., The Alchemists Nightmare: Gold into Lead, the annexation of psychotherapy in the UK International Journal of Psychotherapy Vol 3, NO.1, 1998.
A series of carefully researched arguments against psychopractice professionalisation
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Postle, D., The Professionalisation of Psychotherapy and Statutory Regulation A compilation of two illustrated talks given to the Bristol Psychotherapy Association and British Confederation of Psychotherapists
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Richardson, Anne., Statutory regulation of psychotherapy psychology and counselling: The Way Forward transcript of talk given to IPN London Gathering October 13th 2001

Richardson, Anne., Getting Fit for Regulation by Deputy Head, Mental Health Services Branch, Department of Health 'Public protection is high on the Government's agenda. However, legislative action is likely to be developed before 2003. The professional organisations that represent psychologists, counsellors and psychotherapists have much preparatory work to do
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Totton, N.,The baby and the bathwater:
'professionalisation' in psychotherapy and counselling
In this article Nick Totton looks at psychotherapy professionalisation, the parallels between it and psychoanalysis in the 1940's and 1950's and draws comparisons with the US phenomenon of managed care. He moves on to suggest that 'expert systems' are being substituted for 'local knowledges, rejecting the argument that this is good for the client or that a comprehensive victory of profesionalisation is likely.
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Whan, M., Registering psychotherapy as an institutional neurosis: or, compounding the estrangement between soul and world. European Journal of Psychotherapy, Counselling & Health Vol 2 No 3 December 1999 pp.309-323
This eloquent and carefully argued article is a timely reminder of why statutory regulation of psychotherapy would be terminally damaging. That it comes from a senior member of one of UKCP's participating sections testifies also to the level of ambivalence about regulation in that organisation.
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Young, R.M., 'Psychoanalysis and Psychotherapy: The Grand Leading the Bland'
'This is my fourth set of reflections on the relations between professional organizations purporting to represent psychotherapy in Britain, the broadly-based and democratic United Kingdom Council for Psychotherapy and the elitist British Confederation of Psychotherapists, dominated by the British Psycho-Analytical Society .
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