Davies J 2006 A Unanimity of Purpose Som

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European Journal of Psychotherapy and Counselling,

December 2006; 8(4): 435–444

The unanimity of purpose: Some


anthropological reflections

JAMES DAVIES

The Research Centre for Therapeutic Education, Roehampton University

One aim of writing a ‘response’ is to tease from the event reviewed its less
explicit aspects, to render implied themes overtly declared and thus, in short,
with the benefit of hindsight, to uncover that which was too ‘close up’ at the
time to be clearly discussed and examined. A response is therefore usually less
a summary or descriptive account than an exposé of an event, one that should
aspire to reveal from the observed event dimensions that would otherwise
remain concealed. It was with this thought in mind that the present
editorial committee considered whether an anthropological assessment of
the symposium might yield some novel reflections. Since I am both a social
anthropologist and a psychotherapist I was therefore asked, and, while due to
my dual position I claim neither any special impartiality nor any special ability
to achieve this task, I do admit to a certain desire to perform it, such was the
importance of the symposium’s theme and the thoughtfulness and ingenuity
of many of those who addressed it. I only hope what little I have to say might
be of some use.
Anyone who reads this current issue will quickly surmise that the
conference constituted one of the most comprehensive gatherings of different
therapeutic traditions assembled in recent years. And yet, as can be expected
from the meeting of such diverse representatives, enough themes emerged for
consideration to intimidate anyone who attempts in a short space a general
appraisal. Therefore, to avoid overwhelming both myself and my readers,
let me focus intimately on one theme alone, rather than pass cursorily
over many. The theme I have chosen, or, as I should say, the theme that has

Correspondence: Dr James Davies, St Cross College, St Giles, Oxford OX1 3LZ.


E-mail: james.davies@stx.oxon.org

ISSN 1364–2537 print/ISSN 1469–5901 online/06/040435–10 ß 2006 Taylor & Francis


DOI: 10.1080/13642530601038212
436 J. Davies

chosen me, was everywhere present at the conference. It was a central


undercurrent to Elisabeth Roudinesco’s paper and presupposed the discus-
sion of Jürgen Hardt’s opening talk; it was considered by the representatives
of each accrediting body, as well as absorbing much time during the
question-and-answer sessions. The theme was that of ‘external validation’ or
what has alternatively been called ‘statutory regulation’. Before I turn directly
to assessing the conference in the light of this theme, I shall first contextualize
the proceedings by making some preliminary anthropological comments on
the condition of the modern therapeutic community.

Three responses to the theme


The therapeutic community in Britain, divided and subdivided into
a multiplicity of schools and traditions, has so far resisted being governed
by any one system of training laws. Yet it is precisely such homogeneous
regulation that the State hopes to impose. Mainly because, it is thought,
standardization works best when the field regulated broadly enjoys internal
cohesion and a unified body of professional values and aims. However,
as such uniformity is by all accounts absent in the therapeutic community,
and as the State furthermore appears uneasy about sanctioning the current
level of diversity, the community’s internal fragmentation has unknowingly
proven the best defence against the State’s governance.1
Given this stalemate we must ask what the future holds for the community’s
relationship with the State. For, if accommodating the diversified condition
of the therapeutic profession is difficult for a State suspicious of such
heterogeneity, how are we then to proceed? Assuming that, and irrespective
of its desirability, some form of government regulation is fairly inevitable
(whether this governance is administered by profession itself, as in ‘statutory
regulation’, or is taken over by a state-controlled agency, as in ‘state
regulation’, remains to be seen), there seem to be three broad or ‘ideal’ routes
out of the quandary this stalemate has brought. Since which of these routes
will be finally selected will influence the trajectory of all future therapeutic
training in Britain, let me broadly enumerate them in turn before making
my elaboration of each the central task of my response.
. The State accommodates one vision of therapy to the exclusion all
others.
. The State waits for the community’s internal cohesion before
imposing regulation.
. The State accommodates the diversity inherent in the community,
respecting the equality of all traditions.

Option one: The ‘favoured child’


To discuss the first option in any meaningful manner we must first recognize
some crucial dynamics operative in the community. The way we might do
this is first to acknowledge that no therapeutic training or tradition resides
The unanimity of purpose 437

in de facto isolation. Rather, each is part of a complex network which


in composite forms, in anthropological terms, a community or ‘structure’.
To clarify this structure we must notice that the proliferation of psychother-
apeutic trainings in Britain follows a historical trajectory that bears the mark
of each new school founded. To understand this concretely we might picture
an upturned pyramid with the wide base representing the myriad schools
in the present, and the bottom point the birth of the first training school in the
past. From point to base unfolds an ever-expanding genealogical structure,
along which is marked the naissance of every disparate training institute.
As with any member of a kinship system, if I may speak analogously, a given
institute might trace it roots (via its founding members) from a previous
institution while simultaneously providing roots for some newer descendent
organization, whether this ‘descent’ is approved by the mother institute or
not. Each institute, then, sits spider-like at the centre of its own web of links
and relations, always functioning in reference to its adjoining parts. Between
these institutes we find stratified relations, a continual jostling for legitimacy
and power, a hierarchical ordering not always characterized by harmonious
accord – a fact evidenced by the struggles between the various ‘accrediting
bodies’ that have since the 1970s come to partition these disparate trainings,
often strategically, into therapeutic traditions.
At the Therapeutic Training after Freud conference, representatives
from most of these accrediting bodies were present, allowing attendees to
hear directly what training standards each tradition embraced and in what
direction each strove in respect of statutory regulation. One fact emerging
from the various disclosures was that certain accrediting bodies were pursuing
regulation more vigorously than others. An upshot of this disparity was a
growing unease among delegates who had not hitherto fully realized this
inconsistency. As one senior delegate mentioned to me privately between
sessions, ‘I still don’t get the sense that these bodies are working together
as they should vis-à-vis the state; they seem to rather compete for the State’s
approval against each other’. One palpable feeling behind the scenes was that
bodies such as the BACP were far in advance of others in pushing their
agenda through with the government. As one delegate put it, ‘the BACP
is perhaps one of those best suited to become the State’s ‘‘favoured child’’’,
the assumption being that the State is seeking some such favoured party
whose training vision it may institute as the baseline ‘standard’.2
When searching for reasons why newer bodies are thought more
attractive to government regulators it will be useful to have recourse to an
anthropological distinction in order to understand two broad species of
institute comprising our community: those which tend to appeal diachronically
for legitimacy and those which rather appeal synchronically. Established
traditions are more able than newer traditions to gather status by appeals
to the past. Thus they are more inclined to look to their various founding
members, traditions and their previous associations with authoritative
institutions (e.g. academe and especially medicine) for ratification. In this
sense their petitioning the past is a wellspring of present legitimacy, a strategy
to which newer psychotherapies, without a long tradition of authority behind
438 J. Davies

them, are less able to have recourse. Newer trainings in recent years have
therefore sought legitimacy from alternative sources – i.e. synchronically.
They have appealed to higher-prestige, present-day institutes residing outside
the therapeutic community – e.g. either by establishing horizontal alliances
with universities which ratify courses or by adapting their research traditions
to current government-initiated REA regulations, etc. This search for
legitimacy from contemporary institutions makes them not only more
inclined to negotiate with the State (the State, after all, being the conferrer
of legitimacy par excellence), but better equipped to do so insofar as newer
schools are freer of the conservatism that can inhibit ready adaptation to
modern state preferences.
This more fluid position enjoyed by bodies that regulate newer trainings
places them in an interesting position in relation to those that regulate
more established institutes. As another conference delegate confessed to me
informally:
Many realize that there is kind of a class-structure in psychotherapy where the privileged,
the older traditions, have resisted change to a system which places them, in terms of prestige,
on top. The new bodies sense this and thus push for democratization by any means possible –
this conflict of interests creates tension in a system where certain parties want continuity
and others change.

Not that this tension need be wholly negative, for it has compelled
traditions reluctant to speak to each other into animated discussion. What is
more problematic is if what is feared becomes manifest, forcing, as Nick
Totton has phrased it, the ‘local knowledge’ of individual therapies to become
subordinate to an ‘expertise’ or ‘standardized’ model which suppresses
variations in practice and training (e.g. if the State mandates across the board
a practice particular to one tradition – e.g. the BACP’s that personal therapy
for trainees should not be mandatory). While such standardization will not
offend the party whose vision it privileges, it will generate vigorous opposition
and dissent from traditions whose values it contradicts. The fear that the
powerful will contrive a rigid structure into which all else are forced to submit,
is one realistic enough to prompt the pursuit of an alternative vision – and
indeed the State has offered one. It runs as follows.

Option two: The imposition


The second alternative is for the State to wait for the community to settle
collectively upon a shared stock of training standards over which the State’s
ratification could be draped without opposition. This option sounds in theory
a reasonable alternative were it not for the fact that its implementation
would require the existence of common community aims and procedures.
However, as Michael Ruskin, a Chair at the Conference, once said, different
psychotherapies not only beget different forms of clinical practice and
divergent professional associations, but dissimilar moral and training
communities (Ruskin 1985). In other words, undergoing professional training
is more than simply a process of ‘knowledge acquisition’ or a process of
The unanimity of purpose 439

‘clinical and cognitive instruction’, it is a process of becoming a member of


a given tradition whose professional values may contradict those of its
neighbour.
That different trainings inculcate values idiosyncratic to them will always
be a potential source of conflict in a community required to decide on
a shared stock of training standards. As divergent traditions institutionalize or
‘operationalize’ their particular therapeutic ideas, using these ideas to justify
the training decisions they make, wholly irreconcilable training practices
emerge. For instance, that Lacanian trainees eventually decide for themselves
when they are ripe for accreditation may bewilder Kleinians whose theoretical
canon is bereft of concepts that can justify this procedure. Likewise, while
Rogerians can square their theoretical beliefs with the view that personal
therapy is unessential to training, the same opinion espoused by a Freudian
would render him at best eccentric in the eyes of his peers. In short, each
tradition’s therapeutic ethos is rarely confined to its therapeutic frame,
but rather spills out beyond the established boundaries to legitimate its
specific form of training practice. While it may be perfectly right that each
tradition honour its principles by legislating upon them carefully and
manifesting them responsibly, we are still left with a potentially volatile
situation when reconciliations are either obliged from without or sought
for from within. Given this state of affairs, we are forced to ask, is the State
unwise to await consensus?
One point that could be inferred from the conference proceedings was
that to recruit the principles of one’s own tradition (or the supposed
superiority of one’s own tradition) to argue against the training practices of
another is wholly redundant in any ‘partitioned community’ such as our own,
mainly because it presupposes a common ground of shared professional
values which, for the reasons I have stated, is absent. Yet, despite this absence,
there were various occasions when delegates assumed such cohesion in their
papers and comments. For instance, in his stimulating paper, Darian Leader
used the distinction between unconscious and conscious processes to argue
for the necessity of personal therapy in training. ‘If our conscious demands
and wishes mark unconscious desires, then surely the wish to train as a
therapist must be put in question by any kind of analytic work’ (387) – our
unconscious motives to become a therapist must therefore be discerned.
Although this argument might persuade those accepting the distinction
between conscious and unconscious processes, it will leave unmoved
those many therapists who do not. The argument thus falters, because it
presupposes wide approval of a principle not comprehensively embraced.
Again, the BACP representative who invoked ‘research-based findings’ to
argue that ‘there has been little empirical evidence that personal therapy for
therapists has any effect on client outcomes’, was simply unconvincing to
members from traditions who look upon the growth of research-based culture
as intellectually naive and aesthetically untoward. As Leader reminded us,
‘the whole of the evidence-based research agenda has forgotten . . . the last 100
years of research in history and philosophy of science and sociology that puts
in question the naı̈ve opposition between evidence and authority’ (389).
440 J. Davies

In short, the diversity of starting assumptions from which different


arguments were built did little to reassure the onlooker that, if the State
holds out for internal cohesion long enough, all will come to happy fruition
in the end.

Option three: The feasible alternative


One outcome of the conference was that many delegates caught a glimpse
of the route out of the impasse between the community and the State.
Conclusions rarely come by until all the facts are gathered in and as the facts
in this case materialized only from the ‘coming together’ of diverse training
bodies, this novel meeting produced an unlikely ‘emergence of facts’ from
which could be inferred unexpected conclusions and alternatives. Two such
alternatives we have already discussed – namely, that the ‘favoured child’
option will entail the dissatisfaction and unrest of the remaining community,
and, second, that it is futile for the State to wait for common standards
to emerge from an inherently divided profession. The problematics of these
alternatives ask us to look elsewhere for a suitable substitute. One such
alternative emerged from conference itself, one with which the many delegates
from different accrediting bodies seemed to agree – if at times only by
implication. I believe this alternative can be summarized thus: if state
regulation is to proceed there needs to be community unanimity, not of the
kind desired by the State (unanimity of standards) but of the kind protecting
the rights of each constituent body to practise and transmit its form of therapy
in the manner its tradition sees fit, that is, there must be a unanimity of
purpose insofar as the community must pull together as a community to protect
its diversity from outside imposition and any self-interested politicking
from within. Each fragment must subordinate its taste for potential gain
(whether economic or symbolic) to its respect for the rights of its neighbours
to practise, develop and teach their craft for as long as it is demanded.
Counsellors respecting the rights of analysts, and analysts the rights of
counsellors, would be mandatory for this objective.
Darian Leader seemed to presuppose such mutuality by his call for different
traditions to dialogue with each other, ‘How strange . . . that so many of
us embrace the idea of external validation before even considering the idea
of internal critical dialogue between our groups’ (389). Such a dialogue, it
may be assumed, as well as stimulating possible creative mergers, will foster
toleration for traditions rendered suspicious by their unfamiliarity. David
Tuckett also presumed the emergence of a more integrated field though his
model of ‘transparent guidelines’ devised to assess clinical competencies. The
strength of this model was that it ‘could be applied and is applied in other
therapies’. This comment sent out the message to the body of delegates that
he took the rights of other traditions seriously. Nick Totton (IPA) was perhaps
the most explicit in his call for the respect of diversity, stating that ‘[i]f any
arrangements for psychotherapy and counselling need to be made at
all . . . then they need to reflect the true variety of the field, which . . . is much
The unanimity of purpose 441

more like a rainforest than like a monoculture’ (427). Again, Elisabeth


Roudinesco’s appeal for the ownership of therapeutic knowledge to be
dispersed through more ‘independent’ institutions such as universities and
research centres critiqued the exclusivity of many institutes, which have
inculcated not only particular clinical traditions but particular prejudices
against alternative practices.
That such ‘idealistic’ pronouncements will raise wry smiles in certain
quarters is a regrettable but inevitable fact, especially given the current
overcrowding of the therapeutic market, which is giving community
competitiveness a decidedly sharp edge. If I may be allowed a digression
to illustrate, Neville Symington once took issue with the ‘professional myth’
that patients/clients depend upon their therapists more than the contrary.
Not so, proclaimed Symington (1986, 329), therapists’ need for their patients
is far greater, but I would add not only for the reasons he enumerated.
Without patients there are no professional associations, economic resources,
clinical practices or training schools, there are no journals, conferences
or conference responses; in short, our very legitimacy and professional
raison d’être depend exclusively upon patients’ continued attendance.
While we might assuredly believe that the degree of human unhappiness is
such as to ensure the continued livelihood of many therapists, we are
not so certain as to what kinds of therapeutic practices are guaranteed.
A flooded market means yesterday’s brand may tomorrow become obsolete,
a concern which has led many practitioners to perceive in rival therapies
only those features which seem to justify decrying their rivals wholesale – a
dismissal which in turn will erode the unanimity of purpose needed if the
community’s pursuit of fair and egalitarian statutory regulation is to succeed.
But what is the alternative to mutual respect and decency? Two papers at the
conference warned us.
In her paper Elisabeth Roudinesco gave us an intimate insight into the
struggles for regulation in France, where there has been no unanimity of
purpose. ‘Psychoanalysts’, she tells us, ‘have actually demanded that the
state enshrines in law their status as distinct from that of psychotherapists . . ..
In the country of Revolution psychoanalysts are demanding aristocratic
privileges’ (374). This search for distinction has also been adopted by the
cognitive behaviourists, who have been ‘very vocal, very violent. They wish to
suppress the teaching of psychoanalysis in psychology departments; they
continually call Freud a charlatan’ (374). In France the profession is at war
with itself, traditions against traditions and fragments of traditions against
other fragments. In fact, as a consequence, ‘The law . . . which has been
proposed to regulate the situation is the worst possible one, and it is not
workable’ (374).
If in France such wrangling has led to the discontent of all, in Germany
the search for medical sanction has brought many unpalatable side-effects
for some traditions that have secured it. Jürgen Hardt’s paper showed that,
while the regulation of psychoanalysis in Germany brought many gains
(e.g. guaranteeing that analytic therapy would be funded by the Health
Service), it also brought many losses. As psychoanalysis integrated into
442 J. Davies

medical culture, it lost its autonomy step by step, gradually handing over the
privilege of defining its practices and training procedures to the monolithic
culture of medicine. Psychoanalysis became solely identified as a ‘medical
cure for neurosis’, losing its moorings in Freud’s original vision of analysis
as a depth psychology concerned with inculcating a new radical vision of the
person and a pragmatic philosophy of self and life.
In Britain we are fortunate that medical pragmatics do not currently
determine the regulation of therapies and that the various traditions of our
community still retain some amicable relations. While this may offer some
cause for optimism, noticing how the push for regulation has developed
elsewhere offers a warning. The rush for recognition and security with
which most of our traditions are now occupied cannot be so powerful as to
blind them to the consequences of the ‘each against all’ mentality that has
dominated elsewhere. A fragmented community is a weakened community,
proliferating, for each separate component, its potential number of
antagonists.
That the conference proceedings suggested that the traditions of our
community could actually unite vis-à-vis the more powerful institution of the
State (e.g. by rejecting ‘state regulation’ for ‘statutory regulation’ – namely,
opting to govern ourselves under state sanction).3 Establishing this unity
is consistent with how the community in Britain has always functioned.
Throughout our history individual training institutes have continually formed
strategic alliances with other institutes whom at different times they have
opposed. For instance, the wrangling that once characterized relations
between different analytic institutes (e.g. the Institute of Psychoanalysis and
the Society for Analytical Psychology) has today receded to allow an amicable
alliance under the umbrella of the BPC. In fact, beneath this canopy now lie
a myriad of analytic schools that at one point resided in conflict. Unravelling
the problem of this change, this softening of enduring rivalries, is assisted by
noting that all such ‘segmentary alliances’ imply the proximity of a greater
external danger, for nothing better resolves the enmity of old adversaries
than a new, nearing and shared threat. As the threat today, as Nick Totton
phrased it, comes from an ‘expertise model’ that could be imposed from
without, our alliances could be extended to encompass the protection of the
traditions themselves. In other words, in addition to the protection that
our individual institutes now enjoy under their various accrediting bodies
(the BPC, UKCP, BACP, etc.), we might think of an informal overarching
body established with the sole purpose of protecting these traditions from the
forces of homogenization pressing upon us (we think here of the State’s
request that we enter the Health Professions Council, and thus concede
regulation to a state-run agency). This segmentary alliance, forged at a higher
level of abstraction, might be the best response to the challenges that we as a
community now face.
In the end, offering these general reflections I believe to be articulating
not only a private predilection, as well as a wider hope growing within
the community, but also a realistic option that may be preferable to the
alternatives outlined in this paper. Indeed, that the conference at Roehampton
The unanimity of purpose 443

University took place at all was evidence enough that our traditions can talk
and that some kind of unanimity of purpose can be established. This for me
was the true lesson of the conference, one that in this response I have worked
to highlight, for it is only by recognizing a latent possibility that we can begin
the arduous task of working to exploit its potential – a fact that all those who
work with patients/clients know only too well.

Notes
[1] The State’s resistance to heterogeneity is well-documented. As Abram
and Morgan-Jones stated, as early as 1975, ‘perceiving that there
was some conflict amongst psychotherapists. . .the DHSS stated that
legislation would not be possible until a coherent picture of psychother-
apy could be presented’ (Abram and Morgan-Jones, 2001, p. 34). This
message was again repeated in 1993: ‘Before official recognition can be
considered we will need to be satisfied that it represents all the major
psychotherapeutic approaches’ (Pokorny, 1995, quoted in Abram and
Morgan-Jones, 2001, p. 34).
[2] This feeling has been emphasized by the National Council of
Psychotherapists who write on their website: ‘Without open consultation
or discussion, the Department of Health has used £96,000 of public
money to selectively sponsor two of the field’s largest trade associations
in an attempt to overcome its frustrated efforts to regulate the field.
These associations [the BACP and UKCP] are effectively being given
the power to define job titles and roles, and deem what practitioners
training and qualifications will be acceptable’. See ‘Governments
Plans for Statutory Regulation are Furtive, Defy Research Evidence,
and Let Big Business Carve up the Field’ Available at: < http://
www.natcouncilofpsychotherapists.org.uk/warning.htm> (accessed July
2006).
[3] But it is not only the BACP and UKCP that are under suspicion. On the
website of the College of Psychoanalysts we read a passage written in
April 2006: ‘BPC continues to engage in discussions with the AP-PP
Section of UKCP. However, BPC still publishes nothing to the outside
world on its proposals in regard to state regulation. Almost a year ago
they launched their new website with a News section. In fact no news has
ever been posted there, other than the tantalising statement ‘‘This
section is currently being developed’’. There is still no indication
of whether they intend to make their own separate application
to HPC. . ..The question of state regulation remains a serious issue
and it is surely incumbent upon all the relevant voluntary regulatory
bodies to be open about their proposals, which are likely to have a lasting
effect on all practitioners.’ See, ‘Latest Developments towards
State Regulation’. Available at: < http://www.psychoanalysis-cpuk.org./
latest%20news.html l> (accessed July 2006).
444 J. Davies

[4] For a succinct overview of this distinction see: ‘Latest Developments


towards State Regulation’. Available at: < http://www.psychoanalysis-
cpuk.org./latest%20news.html l> (accessed July 2006).

Reference
Symington, N. (1986). The analytic experience: Lectures from the Tavistock. London: Free
Association Books.

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