[In D. Pilgrim (ed). Psychology and Psychotherapy. London: Routledge & Kegan Paul, 1983]
PSYCHOTHERAPY AND PSYCHOLOGY
Telling somebody about your troubles in order to find some relief from them is neither an unfamiliar nor a new experience for most people: it happens every day, in families, between friends, in bars and barbers' shops, vicarages and doctors' surgeries, and has been happening, in one form or another, for a very long time.
As far as psychotherapy involves this kind of activity, then, it would not seem to need much in the way of justification. But, of course, there is much more to psychotherapy than this. Psychotherapists are, or are supposed to be, especially expert in the nature of human psychological ills, have degrees and qualifications, professional organizations, and expect to be paid for whatever comfort they dispense. And so it seems reasonable to expect them to have something more to offer than just a sympathetic ear or a piece of friendly advice. When professional claims are made, expectations established among clients, and money changes hands (even if only indirectly, as in the British National Health Service), it becomes important to establish a solid justification for psychotherapy as a discipline.
Because, perhaps, of the uncritical faith which we tend to invest in our established institutions, it is hard for the layman to doubt that such justification must exist. Psychotherapists are, after all, like other professional experts, specially educated, trained, and accredited; they are, in some cases at least, supported by academic and medical authority; their services may be sought through the official channels of the National Health Service. Such a person could scarcely be thought to exist in such a setting were he or she offering nothing more than what could be obtained from a spouse, mother, best friend or barmaid.
It is not my intention to suggest that no psychotherapist has more to offer than this, but I do wish to argue that the kind of justification for our activities commonly stated, or at least implied, cannot be substantiated in any convincing way. In particular, those of us whose involvement in the psychological therapies stems from a background in psychology often like to think, I suspect, that our therapeutic practice is guided by the psychological discoveries which have been made in academic laboratories - that we are, in other words, applied psychologists who can, in defence of our professional activities, appeal to established scientific laws and principles. For reasons which will, I hope, become apparent, I do not believe that this is a tenable position, and if we try much longer to hold onto it we shall find ourselves, from a theoretical point of view, less rather than more credible than the sympathetic layman. This is not to say that I see credibility, pure and simple, as an end in itself; it is more my hope that by achieving an adequate theoretical understanding of the process of psychotherapy we may in the long run make it easier for effective psychological help to be available to people without recourse to any particular groups of experts.
Ever since the beginnings of psychoanalysis, psychotherapists have been desperately anxious to establish the validity of their credentials - both in order to earn the respect of psychological and medical colleagues and, no doubt, to justify their professional (fee-taking) status. To be rather more charitable, they have also been concerned to establish the degree to which their undertaking works. During the past century, of course, the way to justify an activity of this kind has been scientifically - it is the scientific community which has to be satisfied that therapeutic treatments are reputable and claims supported by satisfactory evidence. However, as an object of scientific study, psychotherapy has not stood in great repute. From the moment that Freud put pen to paper, experimental psychologists, as well as many medical specialists, have looked with mistrust at the activities and theories of those calling themselves psychotherapists, largely because of the difficulties encountered in framing these activities and theories in a sufficiently disciplined and well defined form to allow them to be scientifically tested and validated. As far as it goes, the 'scientific evidence' supports such a mistrustful attitude. Libraries full of published research aimed at establishing the effectiveness of or clarifying the processes involved in a wide range of psychotherapies still give no really clear indication of what the important ingredients are or what is the nature of their operation. Despite this being the case, however, and despite the almost universal importance attached to scientific justification of his or her activities, no psychotherapist of any of the myriad schools of psychotherapy which exist has as far as I know given up practising on the grounds of lack of adequate evidence. There may be a number of reasons for this. It may be, for instance, that psychotherapists are by and large a collection of charlatans who are making too much money to allow their scientific scruples to interfere with their interests. They may be misguided, stupid, or mistaken. They may be pinning their faith on potential rather than actual scientific support for their position. Often, however, they may be being guided by a kind of evidence which, while not 'scientific' in the orthodox sense, seems to have a kind of validity which they are reluctant to discount.
I do not myself believe that this state of affairs has arisen because psychology is a young science which cannot yet reasonably be expected to deliver the goods. Rather, I suspect, it is because the conception of psychological science most widely adopted both in and outside academic institutions is one which, because of the assumptions it makes and the aspirations it embraces, is doomed to failure when applied to psychotherapy. One must of course acknowledge that such assumptions and aspirations have not remained unchallenged in recent years, even from within the institutions where they tend to hold sway; nevertheless, they survive as those conventionally accepted among the vast majority of those who conduct research into psychotherapy as well as by therapists who are conscious of a need to pay lip service to the demands of 'science'.
The assumptions and aspirations which I mean may perhaps best be illustrated by reference to the definition of psychotherapy (taken from Meltzoff and Kornreich, 1970) which has found most favour with the British Psychological Society recently. This sees psychotherapy as an:
informed and planful application of techniques derived from established psychological principles by persons qualified through training and experience to understand these principles and to apply these techniques with the intention of assisting individuals to modify those personal characteristics as feelings, values, attitudes and behaviors ... as are judged to be maladaptive or maladjusted.
Despite its surface plausibility, this definition seems to me to beg just about every factual and moral question which can be asked about psychotherapy. For example, it assumes (a) that there are techniques which can be applied to individuals; (b) that the application can be planful; (c) that there are established psychological principles on which they can be based; (d) that qualification and experience will reveal what the techniques and principles are, and (e) that judgements about what is maladaptive and maladjusted can be made relatively unproblematically.
My objection to these assumptions is not that they are not in principle attractive or reasonable or what I should like to be the case. It is that in my experience they simply do not seem to be valid, and I could believe in their validity only if I suspended belief in my own experience of psychotherapy. For example, I have never found that I can say or suggest things to one patient on the grounds that either my own or other people's patients have in the past been helped by the identical utterances or procedure: in other words, I have not found that I can rely on techniques, as such. Instead, I have to take account of how the patient understands, what he makes of what I say and suggest: I have to negotiate with him or her the meaning of what we are talking about. Over and over again I have to abandon preconceived notions because of the influence the patient has on me. As for 'planfulness', I almost never find that I can predict the way a therapeutic interview is going to go, but can only formulate ideas about what has taken place after the event. Again, I know of no 'established psychological principles' in the formal academic sense: the psychological literature seems rather to attest to the fact that any attempt to establish a psychological principle has been met with a more vigorous attempt to establish a range of opposing ‘principles’, with the result that in no sphere of research have stable paradigms emerged.
The implicit claim in the above definition of psychotherapy that training and experience qualify one to understand and apply techniques blithely ignores the fact that psychotherapists are split into a wide range of different schools, with fundamentally different and often mutually exclusive theoretical ideas. It would be truer to say that qualification reflects more often an allegiance to a prejudice than privileged access to established knowledge. Finally, the making of judgements about what is maladaptive or maladjusted has, as surely nobody remotely connected with the field of mental disorder could be unaware, been the centre of a violent and unresolved controversy for at least the past twenty years.
The assumptions embodied in this definition of psychotherapy, then, reflect wish rather than reality; they are the creation of a scientific mythology which in fact takes almost no account of our actual experience of psychotherapy.
Academic psychology seems to breed in its adherents an unhealthy obsession concerning how far they are or are not 'scientific'. Indeed, what seems to have happened is that what it is to be scientific has in psychology become a question of dogma, which is itself centred upon an appraisal of the methods which natural scientists appear fairly consistently to have used to pursue their enquiries. What inspires this dogmatic approach to scientific thinking seems to be a tacit faith that, by following a prescribed methodological path, scientific authority can be rendered absolute and impersonal; can, in guiding human activity and human intervention, exclude the frailty of human judgement by appealing to such principles as objectivity, lawfulness, quantifiability, generality, stability, determinism (prediction and control), and so on. It is possible that principles such as these are helpful in understanding and manipulating the inanimate and mechanical aspects of our world, and perhaps also the behaviour of organisms 'lower' than man, though even in these spheres of scientific achievement and relatively stable scientific paradigms orthodox methodological dogma has been questioned by a number of eminent natural scientists (the reader is likely by now to be familiar with most of these arguments - if not, I can do no better than recommend Polanyi, 1958). But whatever is the case with the natural sciences it seems to me now beyond question that the view of scientific method conventionally accepted in psychology has not helped us in our attempts to understand psychotherapy. Confronted with this, we have, presumably, at least two choices: we may conclude, as some certainly seem prepared to do, that scientific psychology must concern itself only with those phenomena which will leave its methodological purity uncontaminated, relegating psychotherapy to the realm of the 'healing arts', or, alternatively, we may begin to wonder whether our traditional scientific concepts need revising in order to cope with phenomena to which they should, if we are to remain psychologists rather than physiologists or biochemists, be applicable.
In considering the question of the applicability of a scientific psychology to the field of psychotheraapy, it is of course important to distinguish the practice of psychotherapy from the theoretical understanding of it. Szasz (1979) has argued, in my view convincingly, that psychotherapy cannot in itself be seen as a scientific undertaking, but rather as a moral enterprise. That, however, is not to say that the processes of psychotherapy are not mediated by psychological phenomena which can be studied scientifically. That such study does not seem to be facilitated by the impersonal set of dogmas we have taken to represent science does not release us from an obligation to get properly to grips with the intellectual (as distinct from the moral) problems presented in the experience of psychotherapy. What alternatives could there be to a scientific understanding, apart from believing in magic, or being ready to accept that something is the case just because somebody says so?
Science, freed from a dogmatic interpretation, has its own special appeal not because it guarantees an impersonal route to objective truth, but because it embodies a particular set of values. Most centrally, what is, or in my view ought to be valued is an understanding, elaboration and, where possible, explanation of our experience of the world which is, precisely, not based on dogma or arbitrary authority. Ideally, science is thus a means whereby we convince or persuade ourselves and others of the adequacy of our understanding by appealing to experience which we and they cannot in good faith deny. The fact that science may have developed methods which have proved useful in this undertaking, particularly perhaps in spheres unrelated to psychology, does not mean that such methods are sacrosanct - if at any point they prove inadequate for our purposes, they can be jettisoned without a qualm. What conventional psychological science has failed consistently to do is to take our experience seriously, and yet that is exactly what should have been its task.
It is not even on the whole considered necessary to a scientific psychological understanding to have any experience of the phenomena under consideration. For example, some academic psychologists seem to feel quite at liberty to give 'scientific' opinions about or to conduct research in psychotherapy without having any first hand knowledge of it. This presumably stems from a misguided belief that ‘objectivity’, in the sense of approaching a problem uncontaminated by any familiarity with it, somehow guarantees a more accurate appraisal of its nature. And yet, surely, the very first thing a scientist should do is make himself thoroughly acquainted with the phenomena whose nature he wishes to understand. I find it completely mystifying to see how anyone can know, except in a completely empty and abstract sense, anything with which he or she has not been in intimate physical relation. One can only know the taste of oranges by having had one in one's mouth, and nobody could learn to play the piano by reading a treatise about it. The structure of orthodox, dogmatic psychology is such that it permits people to pronounce with apparent authority upon whole ranges of psychological phenomena about which they know nothing simply because the methodology it espouses is applicable to any set of data, no matter how meaningless, and as long as methodology is seen as the criterion of scientific excellence, we shall continue to be subjected to an apparently endless stream of meaningless research. One cannot know anything about psychotherapy unless one has been in some way bodily involved in it. Those who have been so involved often do know a lot about psychotherapy, but they are on the whole unable to elaborate their knowledge because the structure of official scientific psychology is uninterested in their experience and unwilling to alter its methods and assumptions in order to take account of it. Almost inevitably, to say something truthful about psychotherapy is to violate the dogmas of conventional academic psychology; to be an accurate student of psychotherapy is to be a psychological heretic.
There are many instances of this kind of difficulty in the literature on research into psychotherapy, where often only those 'findings' are taken seriously which conform to current standards of methodological purity. Sloane et al. (1975), for example, in their well known study of psychotherapy versus behaviour therapy, obtain objective measures of personal characteristics of therapists as well as seeking directly the views of patients on the same characteristics of their therapists. Because there is some conflict between the two sets of evidence, the authors are persuaded to pay more attention to the objective measures, though the logical grounds for doing so are far from clear, solely because this is more in accordance with methodological dogma. Again, Jerome Frank (1973), having soberly and dispassionately taken stock of many of the important phenomena of psychotherapy (thereby, one would have thought, advancing the cause of science), then despairingly withholds the possibility of scientific study from psychotherapy on the grounds that the processes involved cannot be reduced to physiological or biochemical events. What seems to be happening in these and other cases is that our assumptions are blinding us to the significance of what is in front of our noses.
If our theoretical structures turn out to be such that our experience cannot be fitted into them without doing it violence, then our theoretical structures will have to be revised. Galileo (see Drake, 1980) complained that the professors of philosophy of his day ‘would have us altogether abandon reason and the evidence of our senses in favour of some biblical passage...’. If one substitutes ‘methodological dogma’ for 'biblical passage', and professors of psychology for professors of philosophy, we find ourselves faced by similar dogmatic constraints. If we took a leaf from Galileo's book, and characterized science simply as the conjunction of practical experience and reason, we might find ourselves free to think about, for example, the phenomena of psychotherapy with results far more fruitful than those we have come to expect from orthodox research. Laying our scientistic prejudices on one side, the first thing we should do is to take our experience of psychotherapy absolutely seriously, and only then use our powers of reasoning to construct a theoretical framework which can do it justice. If in the process we find ourselves in need of unconventional philosophical concepts, that is no immediate cause for alarm and despondency.
Any statement which purports to be scientific in the end stands or falls on the evidence presented in subjective experience, not on its conformity to established dogma. Where our subjective experience overlaps, we are presented with the possibility of debating, persuading, and negotiating with each other the significance of the phenomena experienced. Objectivity thus becomes, not a magic methodology for guaranteeing truth in an impersonal world of ideas, but rather what emerges from a consensus of subjectivities.
If one approaches the psychotherapy literature with the intention of learning from those who have gained experience in psychotherapy, it is my impression that there are sufficient areas of commonality, enough recurring foci of interest, to suggest at least embryonic forms and questions with which a science of psychotherapy might concern itself.
For example, Freud, when not lost in the intricacies of theory-building or carried away by his own mystique, develops undeniable insights into the way neurotic symptoms and defences can disguise painful and distressing dilemmas. Jung, long before Rogers, is clarity itself when discussing the nature of the therapist-patient relationship. Sullivan expounds brilliantly the importance and influence of interpersonal relations in the formation of personality and psychopathology, foreshadowing in many respects the later contributions of Laing as well as of Kelly. Horney develops very helpfully a framework in which to view the kinds of neurotic problems and strategies familiar to all of us. More recently, Peter Lomas (1973, 1981) goes further than anyone in laying bare the nature of what is therapeutic in the therapist's stance towards his patients and its inescapably personal nature, and both Lazarus (1971) and Wachtel (1977) confront with great honesty the commonalities between psychotherapy and behaviour therapy.
More widely, the literature on psychotherapy research is laden with quite consistent hints about what the likely effective ingredients and central problems of therapy are, though frequently these are relegated to the realm of the 'non-specific', not because they are in the least peripheral, vague or irrelevant, but simply because they do not conform to the kind of technical specification dictated by our dogmas. One central conclusion which seems to me inescapable is that fundamentally psychotherapy cannot satisfactorily be cast in terms of anything other than a personal relationship, so that any attempt to standardize or technicize therapy is certain to detract from its proper understanding (see Smail, 1978, for an extended elaboration of this view).
It is unfortunate that a central concern of many writers on psychotherapy has been to defend the theoretical claims of their school against the rival claims of other schools. This has naturally led to an emphasis on the differences rather than the similarities between the ways in which therapists construe their experience. If, however, one approaches the literature with a more charitable attitude, sifting from it those observations and statements which accord with one's own experience of psychotherapy, it may be possible to arrive at a set of statements which could form the basis for a rudimentary consensus around which, eventually, it might be possible to construct a science of psychotherapy which would invite allegiance because of the sense it made of our experience. An extremely preliminary attempt of my own to generate such a set of statements, to map out, very roughly, some of the psychotherapeutic phenomena which seem to me to occur fairly generally in therapists' experience, has resulted in the following list:
Most patients, on first consulting a therapist, do not really know what is troubling them, and their 'symptoms' cannot, therefore be treated at face value.
The '.truth' of the situation has to be negotiated between therapist and patient, and this takes time.
Patients have to trust their therapist, and whether or not they can will depend in part on how honest (genuine) the therapist is able to be.
Therapists cannot avoid influencing patients. To understand patients, also, they cannot avoid drawing on personal experience. Empathy is of course important, but arises between people, and is not a quality (or 'skill') possessed by individuals in some finite amount.
Patients are not the passive victims of psychological (or any other kind of) determinism, but are agents in a social world. Techniques, as such, are unlikely to be effective, but need to be placed in a context of meaning.
Mutual affection between patient and therapist is one of the most powerful therapeutic factors encouraging change.
In order to change patients need courage, which may be only to be found in the context of a confirming relationship.
Self-deception is a universal human phenomenon, and is a particularly strong and ubiquitous feature of 'neurotic' strategies. Thus what people tell themselves about their conduct will often conflict with the apparent meaning to others of their conduct. One is not in a specially privileged position to interpret the meaning of one's own conduct. (This view is, of course, closely related to concepts of conscious and unconscious.)
Therapists cannot always act from reflection and deliberation, and much of their contribution to therapy will be spontaneous, understandable only after the event.
There is no standard way of being therapeutic, and hence the ideal of the technical handbook, however complex and detailed, is doomed to failure.
In the vast majority of cases, 'patients' are not 'ill', and ‘therapy' is not a 'treatment' or a ‘cure’.
Patients' problems hinge on emotional pain and psychological distress having origins in their experience and relationships and recognisable to us all.
I have in fact exposed this set of statements to the critical comments of a number of groups of therapists over the last year or so, so far without causing, apparently, great dissent. However, even if a collection of statements such as this could command a measure of assent, one is of course still a very long way from a scientifically viable structure in which to place the phenomena of therapeutic experience. What is still needed is a theoretical psychology which is capable of accommodating and elaborating, not to say refining and extending such observations as these. Personally, I think the nature of our observations suggests the form that such a psychology must take, and indeed it may well turn out that psychotherapeutic experience has a part to play in revolutionizing psychology, rather than, as is more the case at present, psychotherapeutic practice straining itself to conform to the mechanistic ideals of an 'applied psychology' in the conventional sense.
There are indeed signs that a theoretical structure capable of accommodating the phenomena of psychotherapy is beginning to develop on the fringes of official psychology. Behaviourism, although still the predominant theoretical force in clinical psychology, is no longer as popular in many university departments of psychology as it once was, and indeed academics seem to be becoming increasingly aware of the inapplicability of their traditional preoccupations to the living psychological problems of the outside world. Over the past few years Anglo-American psychologists seem also to have become more conscious of a European philosophical tradition which has avoided the positivist and empiricist excesses of our own intellectual establishment, and while phenomenological, existential and structuralist writers from France and Germany tend to have an expressive opacity which fails to lift their views above the contempt of most British academic philosophers and psychologists, a number of their more central concerns (e.g., to do with freedom, meaning, subjectivity, the phenomenology of the body) have recommended themselves to a significant minority of people working in the clinical fields of psychology and psychiatry. These views, combined with an increasing awareness that natural scientists no longer find (if ever they really did) a simple philosophy of objectivity adequate for the understanding of their particular theoretical puzzles, leads to a conception of man not as a passive responder to stimuli, but as, in an important sense, the creator as well as the interpreter of his world, the institutions within it, and the relations between people.
In many ways, things are getting more complicated than might have seemed likely a few decades ago: our theoretical dilemmas can no longer be encompassed within simple oppositions between idealism and realism, mind and body, free will and determinism. For example, psychotherapeutic experience suggests that a person may be both responsible for his actions, and yet unable to account for them (see Smail, 1978 for an account of this apparent paradox); able to initiate action and yet incapable of decision in the sense in which that concept is normally used. Attention has been drawn (Harré and Secord, 1972) to the way we negotiate our reality through the accounts we give of it, and yet, to complicate matters, the problematic relations between language and conduct are only just beginning to surface in the consciousness of experimental psychologists (see, for example, Nisbett and Wilson, 1977; Gur and Sackheim, 1979). The inevitability of man's experience of the world determining his scientific and philosophical (as well as personal) constructions of it also ushers on to the psychological scene a revived preoccupation with moral issues, so that psychology becomes undetachable from morality (see in this respect Poole, 1972; Shotter, 1980).
We have scarcely begun to think, in the English-speaking psychological world, in terms of these categories, but as we gain the ability to do so, I suspect that we shall find ourselves developing a psychology which looks very little like today's orthodox version. The most fundamental difference we are likely to see, in my view, is a psychology which up-ends our established dogma, and takes man as primarily subject rather than primarily object. Instead of a mechanical organism behaving in reaction to a specifiable environment, man becomes a focus of activity conducting himself, in relation to others, in what Roger Poole calls 'ethical space'. It may well be that from a God's-eye-view human beings could be studied objectively, their behaviour subject to prediction and control, much as we might study rats. But unless psychologists manage to close themselves off entirely from commerce with the rest of the world and keep their scientific observations completely secret, there is no logical hope of our achieving a viable psychology of this kind.
The practical consequences of looking at men and women as subjects rather than objects might not be uninteresting. One of the main effects of this might be to turn our attention from what we are to what we do, from our 'objective selves' to our conduct. In suggesting this I am certainly not advocating a modified form of behaviourism: in splitting behaviour from its intention, or meaning, behaviourism lost, in the cause of mechanism, whatever it might have gained from recognizing the difficulties implicit in verbal accounts of psychological processes. The use of the word 'conduct' here is meant to correct behaviourism's mistake by placing activity firmly within the context of its ethical intention, while acknowledging that intentions are not things which people have in their heads.
Traditional psychology has above all else concerned itself with the objective characteristics of people, i.e. with traits, descriptions, diagnoses, self concepts, self / ideal self discrepancies, presentations of self, and so on. All of which suggests that the individual person can be emptied out into a finite number of accurate descriptive labels by which he or she can be fixed, as it were, as an object in psychosocial space. This kind of enterprise takes place in a wider culture in which almost everyone is obsessed with self-as-object. This pervasive concern is most evident in the extent to which people are preoccupied (a) with what people think of them and (b) with what they look like - the body becomes the ultimate object in which we are trapped, inescapably vulnerable to the lust, disgust, derision or adulation of others. We live in, and have helped to create, a society in which a person's entire life can be reduced to an agonized consciousness of being too fat, too thin, too short, too tall; a society in which what people actually do matters not at all in relation to the appearance of success or status they manage to give. In this setting, it can be no surprise that 'therapeutic' psychologies become more and more concerned with the management of appearance and the development of 'skills' by means of which others may be deceived into believing that we are invulnerable. Many so-called neurotic patients seem to me to be people who have not been able to conceal from themselves an inarticulate awareness that they have been mystified and crippled by the bludgeon of objectivity, and have not been able to obliterate totally the defencelessness which lies, I believe, at the centre of our being.
A culture, and indeed a psychology, which took proper account of subjectivity, however, might release people from this kind of objectified status, and allow them to concentrate on what they are trying to do rather than on how successfully they are managing their presentation of self. Bodies might become instruments rather than objects, valuable for what they create rather than valued for what they look like. Beauty would become a relational characteristic (in the eye of the beholder) rather than a fixed possession obtainable from a bottle of skin cream or the consumption of low-calorie bread.
The future course of our relations with each other, from the personal to the global, must in fact depend on what we do to and with each other, not on the success with which we manage to convince each other of our lies. It is only at the cost of despair and, very probably, eventual destruction, that we learn to adapt to a world which takes manipulation and deceit as the fabric of relation, in which the actual consequences of our conduct are obscured by an ever more strident insistence on the rational necessity of our objective constructs, a world in which we are led by moral imbeciles whose actions are presented to us by the image makers as the inevitable response to rational, objective (economic) necessity. Psychologists and psychotherapists must, I believe, decide upon what their stance toward such a world should be, if only because, through their own activities and in their own small way, they either help or hinder its construction.
A psychology adequate to deal with the phenomena of psychotherapy must, certainly, be reflexive, and must acknowledge people as agents in a social world, whose conduct cannot be considered out of the context of its ethical intention. As psychologists and psychotherapists we contribute to an ethically evolving social world in which we cannot validly dissociate ourselves from a process of constant negotiation (concerning what is true, real and good) with its other inhabitants. Nor can we validly maintain the pose of technical experts privileged to stand back and guide others to some kind of objectively determined or morally self-evident goal.
The recent history of clinical psychology in Britain (and presumably even more so in the USA) suggests that psychological therapists are no less vulnerable than any other groups to the temptations of professionalization - indeed, we show every sign of rushing to be seduced by them without even a sideways glance at the kind of moral pitfalls (so ably described by Illich, 1977) we are likely to dig for ourselves and our clients in so doing. And yet if we are to take seriously the reflexiveness of psychology, we shall I think need to consider very carefully what it means to be a professional psychologist or psychotherapist. As far as 'being a psychologist' may be identified by others as an implicit claim to expertise about human nature, it is an embarrassment. It is always painful for psychologists to be asked at social gatherings what they do for a living. The most apt response I ever got to the somewhat shamefaced confession that 'Well, I'm a psychologist, actually', was from a man who, with a patient but rather tired smile, replied 'Ah. Aren't we all'. And, of course, we all are - highly skilled and experienced psychologists who have spent a lifetime developing ways of living in a world which contains other people, observing the regularities of their conduct, and conducting ourselves in accordance with our observations. We can with extraordinary accuracy read the significance of a glance or a minute vocal inflection, react sensitively to the mood of those around us, make lightning judgements about the appropriateness of what to do in this or that situation. In the face of this kind of expertise, when the professional psychologist, because of his commitment to the dogmas of quantifiability, generality, objectivity, etc., attempts, for instance, to reduce human personality to the interaction of two or three so-called personality traits, he risks making himself a laughing stock.
Not only, then are psychologists people, but, much more important, people are psychologists. This being so, it seems to me unreasonable for psychologists to regard psychology as their own special property. Psychology cannot, in other words, be considered a special discipline understandable only to a particular group of professional experts, but consists rather in a conceptual network embedded, at least implicitly, in the general culture, and is in principle accessible to, and is certainly operated by, the members of that culture. I would thus argue that a psychology is successful, or accurate, to the extent to which it unearths or makes explicit the psychological practices and processes of ordinary people.
Now it may well fall to a particular group of people to interest itself in the psychological processes of people in general, but once the nature of such processes has been to some extent revealed, the 'discoveries' involved should not be appropriated by a professional group for it to exploit in its own interest, but should be reflected back into the culture, which may well in turn be modified by them. To be effective, psychological theories have to be practised by the very people to whom they apply. In support of this argument, 1 would suggest that Freud's discoveries, if one chooses to regard them as such, have gained their significance much more from the way in which they have been assimilated and made manifest in the general culture than from the use to which they have been put by the professional groups of analysts which have tried to make them their own property.
One practical consequence of this for psychotherapy, I suggest, is that more important than the technical 'cure' of individual patients (in which the professional therapist acts as an intellectual usurer, lending his concepts, as it were, at interest) may be the enrichment or modification of the psychology implicit in our conceptual culture as a whole. This may be difficult to achieve in any deliberate kind of way, but, if our insights have any significance, it is likely in the long run to be achieved accidentally.
It is possible that a number of observations derived (not necessarily exclusively) from therapeutic practice might prove of more practical value if they were offered up, so to speak, for public consumption, rather than kept simply as the theoretical property of professional therapists. One may perhaps illustrate this through the use of one or two examples of observations already made above. For instance, popular psychology, if one may call it such, has even more difficulty than professional psychology in recognizing explicitly that there is much more to the explanation of conduct than merely the individual's verbal report of what he or she is intending. In fact, of course, even the most psychologically naive layman is all the time judging other people's intentions from their actions rather than their words, and yet when it comes to making the grounds of such judgements explicit, is likely to find himself at a loss; people feel unhappy if they have not got verbal evidence of another's intentions to back their hypotheses about why he or she did something. I have often been struck, for example, by the lengths to which even experienced residential child care workers will go in their attempts to extract from a recalcitrant child, who clearly cannot say why it did what it did, a motivational account of its actions; it would often seem more appropriate on such occasions to offer to the child a suitable explanation for its conduct. Considerations such as these in turn raise questions about the ways in which, popularly, we conceptualize responsibility, blame and fault, etc. From experience of psychotherapy, it seems to me quite clear that people can do something intentionally without being able to say, either to themselves or to others, what they are doing, and are thus responsible for their actions, though perhaps not blameworthy if the actions turn out to be socially unfortunate. Whatever one might feel about the philosophical or linguistic complexity of such issues, it is clear that our everyday conceptual language is not subtle enough to handle the psychological complications which underlie much human conduct. Decisions, again, seem not on the whole to be things which people make in their heads before they act, and many patients, in my experience, are hampered by their culturally determined inability to recognize this as being so; they feel that before they can do something, they have to await the occurrence of a decision.
Now what is important about such insights as these (assuming for the moment that they are insights) is not that psychologists or psychotherapists should attempt to patent them as their own property to be used for their own material gain, but that they should be exposed to a critical scrutiny so that, if valid, they may become part of common conceptual property. What, to take a Utopian view, may follow from this is that psychotherapy may contribute to a popular psychology which could in the end render almost obsolete the need for any specific professional group of psychotherapists. As psychotherapists, certainly, we shall never expunge emotional pain, distress and friction from the world, and indeed the reasons for these are probably political and moral much more than psychological. What we may help to do is develop a more effective understanding of their psychological consequences and complications than seems current at present. The practitioners of such a psychology, however, will not be professional psychologists and psychotherapists, but people themselves.
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