bookREVIEW: What is Counselling & Psychotherapy?
Learning Matters, 2010, pp200
Reviewer David Mazure
This is a superficial account of the history, theories, various working environments, present context and future possibilities of counselling and psychotherapy. It also engages with the central issues facing us as a profession today. It would be a good read for anyone who is contemplating counselling and psychotherapy as a career, or just interested in how our profession works. As regards those of us already in the profession, it asks all the questions we already know and offers little in reply.
I found Claringbull’s book frustrating. In what he admits are interesting and important times he offers us no real guidance as to what really matters in our work. He doesn’t answer the question in the title of his book. He says: “I am leaving you with many questions needing answers! Do you have any? As for me, this is it. My tale is told; my story is done” (p.187). I was disappointed that Claringbull precisely didn’t tell us his story; instead I was left to try and tease it out.
Take the distinction between counselling and psychotherapy. At the beginning he makes very clear that the differences in the various titles used to describe those of us involved in working with emotional, personal or mental health issues are meaningless. “The answer to the ‘what’s in a name’ puzzle is simple: there are NO differences” (author’s emphasis p.4). Yet, faced with the regulator’s desire to distinguish precisely between these titles, he is willing to conclude that a division of these professions might be a good thing! Counsellors would attend to “understanding people and their interrelationships in terms of their social, cultural and organisational contexts”, while psychotherapy “put crudely … is about finding cures” (p.185). But Claringbull doesn’t tell us how counsellors would use their understanding – what they would do with it – and what exactly it is that psychotherapists would cure and how. I found his willingness to set aside his beliefs in the face of opposition disconcerting.
When talking about private practice he says: “it is just another business and the commercial demands of the real world have to be met” (p.125). This sums up the tension he refers to so often when he splits us professionals into ‘purists’ and ‘pragmatists’, pragmatists seeming to be those of us willing to accept readily what the marketplace and regulation hold in store for us, and their capacity to shape our futures. Purists, on the other hand, he sees as being preoccupied with theory, philosophy and principles, and resisting change. Of course there’s no reason why purists (and I count myself as one) should not be perfectly capable of being pragmatic; accepting reality with its demands and compromises. Claringbull had little time for those of us who think deeper and resist the inevitable external forces impacting our profession. “Like all shopkeepers” he advises, “therapy’s traders have a choice. They can adapt their merchandise to the demands of their customers or they can go out of business” (p.121). I found this attitude jarring and believe it to be at the core of the debate regarding regulation, professionalisation and academicisation and what it is we psychological therapists do. Current research is definitely telling us that, while something worthwhile is happening in our work with our clients/patients, no one model is superior to any other. This leads him to look briefly at models of integration and the hope they hold of revealing the essence of our work. He goes on to cite Wampold and Brown (2005) who found evidence that “for whatever reason, some therapists were consistently better than others” (p.184). Claringbull himself has no explanation to offer for this other than “happenstance”.
I feared that in Claringbull’s hands the sought after essence was more muddled than revealed. When looking at Rogers’ core conditions he says, “for some counsellors and psychotherapists, there is only core condition 1 – the rest are irrelevant” (p.101). That condition is that the client and therapist be in productive psychological contact. But, surely, it is Rogers’ principal conditions: to be empathic and truly and transparently present (congruent), with a genuinely loving attitude (unconditional positive regard) that enables the relationship to be productive. In fact, a few pages later, Claringbull implies this when he says it seems “a good-quality therapeutic relationship combined with a productive working alliance usually indicates a positive outcome” (p.112). Yet further on he says that “tomorrow’s supershrink is likely to be a highly skilled technician working within laid-down operating procedures and obedient to measurable outcomes” (p.184). I got the feeling that Norman Claringbull, like most of us, struggled to reveal what is so simple about our work and at the same time so very difficult. His unwillingness to value his own experience: “your ideas are just as good as anyone else’s. They are certainly as good as mine” (p.107), and his willingness to bow to the marketplace and let market forces and government regulation determine what it is we do was perplexing. I was disappointed that he wouldn’t tell us what he has learned from his own practice and what matters to him, preferring instead to give us a thorough account of the current confused state of our profession.
In Freud and Man’s Soul Bethelheim quotes Freud as saying that “Psychoanalysis is in essence a cure through love”. At no point does Claringbull use the word love in his story of psychological therapy. For me love does matter in our working relationships with our clients. In my opinion it is love that us ‘purists’ and ‘idealists’ are trying to protect, fearful that techniques, competences, and academic theorising will take the soul out of the psyche. Perhaps he is right and our profession will be radically transformed by these forces, and those people entering the profession need to hear that. That thought depresses me but as a purist as well as a pragmatist, I still want to stay in touch with the depths that inform our profession and its work, and fight for them, irrespective of the context or the time constraints in which they might need to be employed.