Counselling in a Cruel World

Invited Address at the Regent's College School of Psychotherapy Graduation Ceremony, 1995

I have first to admit that, though honoured to be asked, I was to begin with a little uncertain about whether I should inflict my views upon you on this occasion. I am not, after all, the most enthusiastic advocate of counselling and psychotherapy, and I didn't want to seem to be casting a dampener over proceedings which are after all a celebration by calling into question aspects of a vocation which some of you, perhaps, have started out on only recently. However, after some gentle persuasion by Emmy1 (who must therefore carry a small proportion of the responsibility for what follows), I reflected that I still do myself practise clinically after all these years of questioning and doubt, and I still do regard it as probably the most useful thing I do. So maybe I could 'accentuate the positive'.

The trouble is that accentuating the positive is not really my style. Mind you, I'm not in my own view quite as gloomy and negative as some people accuse me of being. One well known therapist had me down as 'clinically depressed' a few years ago, which pleased me considerably - it's a sure sign you've said something significant if people start diagnosing you in public. So although I'm not, I think, quite as bad as that, I do find that, in order to reach the valuable core of psychotherapy and counselling, one does have first to clear away an awful lot of confusion, if not downright nonsense. But anyway, I will try to include in these few brief words this evening a view of what I see as useful and valuable about what we do.

One reflection which some people might find cheering (though I can't really say that I do) is what an extraordinary success story counselling and psychotherapy have become. Business, after all, has never been so booming as it is today, with the need for and assumed benefits of counselling on practically everybody's lips. Radio and television news report that even the jurors at Rosemary West's trial were offered counselling to tidy up the emotional repercussions of their ordeal; indeed the hardened hacks reporting the trial were also apparently given the opportunity to have their sensibilities soothed by counsellors. What about us poor viewers and readers? Soon, no doubt, there will be a counselling service for 'post media-consumption trauma' - in fact there's an idea for any of you who may be wondering what to do with your brand new qualification! I wonder if Rosemary West herself was offered counselling to work through her feelings about her sentence; I don't suppose she was felt to deserve it.

Whatever its merits - and one thing we do know is how difficult they are to establish scientifically - counselling is all the rage, and there seem no limits to the extent to which the market can expand. It is of course now a largely deregulated market, and becoming increasingly competitive. There's a good deal of uneasy jostling going on between the various professional, semi-professional and downright amateur groups involved in the field; lots of pre-emptive definitions are being made of 'psychotherapy', 'psychological psychotherapy', 'counselling', 'counselling psychology', 'psychodynamic psychotherapy', etc., etc., each with its own appeal to the 'rigorous training' undergone, the ethical safeguards established, and so on.

Not a great deal of this - quite possibly not any of this - has to do with the therapeutic or intellectual value of the various theories and practices involved. It has to do with what is so often closest to our hearts: money and the need to make a living. We don't tend to talk very honestly about these things, but there's nothing new and nothing shameful about them. Here's a pretty frank confession of pecuniary interest by one of the earliest members of our profession:

A patient of mine with whom I have been negotiating, a 'goldfish', has just announced herself - I do not know whether to decline or accept. My mood also depends very strongly on my earnings. Money is laughing gas for me. I know from my youth that once the wild horses of the pampas have been lassoed, they retain a certain anxiousness for life. Thus I have come to know the helplessness of poverty and continually fear it. You will see that my style will improve and my ideas will be more correct if this city provides me with an ample livelihood.

If you don't know it already, you will probably have recognized from the style that this acknowledgement of rather basic motivation comes from none other than Sigmund Freud himself, writing in 1899 to his friend Wilhelm Fliess2.

But suppose we do try to detach ourselves just for a moment from our perfectly legitimate interest in counselling and psychotherapy, bury the bones of contention over which we inevitably squabble amongst ourselves about our qualifications, credibility, and so on, and stand back for a cool appraisal of the field: what might strike us?

Well, I can of course only really talk about what strikes me, and the first thing that does is just what an extraordinary phenomenon of the Twentieth Century psychology and psychotherapy have been. John Passmore, in a wonderful book some of you may have come across called The Perfectibility of Man3 traces the ways in which, since the Greeks, we have sought ways of perfecting human nature. While discovering that absolutely nothing dreamed up in modern approaches to therapy and counselling does not have a precedent in much earlier times, one cannot but help reflect from reading this work how much our own time has become taken over with the idea that the person can transform him/herself, or be transformed, through a process of psychological intervention of some kind.

However, the historical lesson that comes from Passmore's work is, for me, that perfectibility is a chimerical goal. Centuries of hard effort through just about every means that can be devised suggest that human nature is not to be shaken out of its ambiguous and often tragic mould and that no easy - or come to that even difficult - solutions are to be found to our so often painful struggles with life. And yet, with psychoanalysis just getting into gear at the beginning of the century and counselling the business success story at the end of it, here we are more hopeful than ever that we can solve through therapy some of the torturing riddles we are set concerning life and relationships. That there is nothing new about this hope is even more starkly demonstrated by Keith Thomas's book Religion and the Decline of Magic4 which I think shows us more clearly than any other some of the more recent ancestry of our trade, that is in the practices of sorcerers and astrologers of the Seventeenth Century.

Although one could in some ways call the century which is about to close the Century of Psychology, and possibly even quite easily persuade oneself that this indicates some kind of intellectual advance over previous centuries, there is one quality of the triumphant progress of psychology, and in particular psychotherapy, which strikes me as rather strange, and that is how split off it is from the events, and to some extent also from the culture of the world around it. In his extremely readable account of the 'short twentieth century' (i.e. from 1914 to 1991) called Age of Extremes5, Eric Hobsbaum's picture of our dark and terrible times - the 'most terrible in Western history' according to Sir Isaiah Berlin - contains brilliant synopses of the cultural accompaniments of the wars, famines and revolutions which have beset us, but not one mention is there in his index of, for example, Freud or Jung or any other well known figure from psychotherapy or psychology.

Now in one respect this does of course have to be seen as a pretty serious omission, but in another I think it is quite symptomatic of the role of psychology in our times. For, just as Freud and Jung et al ruminated and squabbled about their notions of, for example, slips of the tongue and latent homosexuality, alchemy and the archetypes while Europe exploded around them into revolution and war, so in our own day we tend to keep our gaze firmly fixed on the 'inner worlds' of our patients and clients while the established structures and institutions of society undergo, with incalculable effects, an unprecedented disintegration .

To compare the kinds of bland philosophies which so often (though of course by no means always) underlie the therapeutic enterprise with the actual experience and activity of, say, significant figures of the century, reveals a stark incongruity. Take, for example, the banalities which have been created by the psychobabble of our industry - ideas about 'personal growth', 'peak experiences', 'individuation', 'working through', 'unfinished business', 'taking responsibility', etc., and try to see if they can make sense of the life of, say, Dmitri Shostakovich. How would a psychotherapist even begin to account for the processes whereby the horrors of Stalinism and the Second World War became transmuted through the confusion, ambivalence and pain of this one genius into some of the most profound and moving music of all time? One could only attempt it by reducing and banalizing his life and work in the same way that Freud reduced and banalized the role of Oedipus in the Theban legend, i.e. by turning matters of enormous social, cultural and historical significance into merely personal psychological struggles between desire and conscience.

Even though I wouldn't for a second question the intelligence, integrity or good intentions of its principal figures, it does seem to me that there is often an amazing naivety, as well as an unconscious grandiosity, about much of therapeutic psychology. Maybe it's because we're so focused on individuals, 'inner worlds' and relationships that we fail to notice that people's troubles stem not so much from what they cannot understand and take responsibility for themselves as from the influences upon them of a social world over which they have very little, and often no, control.

The kind of naivety I mean is evidenced, for example, in Carl Rogers's idea that international relations could be significantly improved by representatives of governments getting together in encounter groups. As if all that's needed to tidy up international politics is for people to understand each other better. The difficulty as I see it is that it's not understanding which is the problem; in fact I don't think it is all that hard for us to understand the nature of our predicament and see what needs doing - and where we do have problems with that, therapy and counselling can indeed help. The real difficulty, rather, is in achieving what we can see needs doing within a social structure which is dead set against our succeeding.

For most people - and the longer I live the more it seems to me that it is for all people - life is difficult. Even for the minority who are not struggling with material deprivation, oppression or the threat of violent unrest, life is beset with, at the very least, risks and insecurities of all kinds, and ends inevitably in loss. The psychoanalyst Roy Schafer recognizes this clearly where he talks about the 'tragic view' of life and suggests that therapy needs to address its own limitations in the light of the inevitable tragedy of personal existence6.

This of course does not mean that life is not worth living, nor that we should lose our sense of the utter mystery of life in shallow pessimism or cynical despair. But few of those who have the courage unflinchingly to look life in the eye and the power to communicate what they see - artists, thinkers, scholars, writers, commentators - avoid striking a sombre note, however uplifting their work may be.

Alongside the likes of these, the nostrums of counselling and psychotherapy, particularly as they get sieved through the consulting rooms of California, can seem embarrassingly superficial, if not merely fatuous (even when, as with Hillman and Ventura's We've had a Hundred Years of Psychotherapy and the World's Getting Worse7, they are attempting therapeutic self-criticism). This comes about not through therapists' stupidity, nor solely from their self-interest, but as much as anything from their hope, their desire, or even their faith, that the individual can, with help, do something significant about his or her predicament. The trouble is that the very intensity of the hope blinds us to the tragic reality of life in a world which controls us far, far more than we control it.

However much insight we get - and therapy is good at establishing insight - our ability to alter things depends not on our will but on the powers accorded us by a social environment upon which we have only the most minuscule influence. I'm afraid that it is simply not the case that, given the chance to reflect and experience fully, people will find the way to their own salvation, simply because potential salvation is not in their own hands.

However, the fact that this central tenet of what one might call the naive philosophy of counselling is wrong should not lead anyone to tear up their degrees or diplomas. For what counsellors and therapists actually do is very different from what the naive philosophy would suggest.

Above everything else we offer human solidarity to those who consult us. I am convinced that this is by far the most potent factor in counselling and therapy, and the least well understood. It was certainly better understood at the time when Paul Halmos wrote his classic The Faith of the Counsellors8, and is certainly very well understood by Peter Lomas, as he demonstrates in his most recent book Cultivating Intuition9, but since Halmos wrote his book in the mid sixties we tend to have retired into technical mystification and professional posturing rather than elaborate the insight that the most helpful thing we do is offer ourselves to clients as someone who is on their side.

By being on the client's side I don't just mean emanating 'unconditional positive regard', but actually putting the personal resources you have been able to develop to cope with life at the disposal of the person who is consulting you. Struggling with them to understand their predicament and to devise strategies for coping with it. Not diagnosing them, not judging them morally or aesthetically, not trying to force them into some half-baked mould for what human beings 'ought' to be like, but standing alongside them in their struggles with a cruel world. It is important also to avoid sentimentalizing therapy: it is neither possible nor sensible to expect to be able, as some have suggested, to love all or even most of your clients. But it is possible to treat people with politeness, kindness and respect. We are, after all, the equals of our clients, not their superiors.

Therapy is an art, and all therapists are different. Judging their differences in style as 'better' or 'worse' is as silly as comparing Rembrandt and Picasso. We help people as the people we are, with what we've learned about life. If we haven't learned anything much, we're probably not going to be that helpful, but one thing we can be pretty sure of is that no one person, or group of people, or brand name therapy, has 'the' answer. Life is a struggle, and all too often the only person to be found who can help with it is a counsellor or psychotherapist. That places upon us quite a heavy responsibility. A couple of days after writing these words, I was very happy to see that they accord very closely with an article by Emmy Van Deurzen-Smith and recently published in Changes10. Knowing that you will have almost certainly been getting an eloquent account of this view of counselling and therapy from her - and if you haven't you should read the article! - absolves me of the need to elaborate on it further myself now.

I could say a lot more, especially about issues like 'dependency', 'time-limited therapy' etc., which seem to me to mistake the very nature of the undertaking, but I have in any case just about reached my allotted time. I do very much hope I haven't either enraged or depressed you, and I hope I've made it clear that I do see counselling and psychotherapy as honourable pursuits, to be undertaken with modesty as well as gravity.

David Smail

Regent's College, 16.12.95

1 Emmy Van Deurzen, at that time Academic Dean of the School

2 Masson, J.M. (ed). 1985. The Complete Letters of Sigmund Freud to Wilhelm Fliess 1887-1904. Cambridge, Mass. & London: Harvard University Press. Letter of 21.9.1899.

3 Passmore, John 1970. The Perfectibility of Man. London: Duckworth.

4 Thomas, Keith. 1973. Religion and the Decline of Magic. Harmondsworth: Penguin Books.

5 Hobsbaum, Eric. 1994. Age of Extremes. The Short Twentieth Century 1914-1991. Harmondsworth: Michael Joseph, Penguin Books.

6 Schafer, R. 1976. A New Language for Psychoanalysis. New Haven and London: Yale University Press.

7 HarperCollins, 1993.

8 Halmos, P. 1965. The Faith of the Counsellors. London: Constable

9 Lomas, Peter. 1994. Cultivating Intuition. Harmondsworth: Penguin Books.

10 Emmy Van Deurzen-Smith (1995). Letting the client's life touch yours. Changes,13,293-298.

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