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Engaging political gear Should we allow psychotherapy and politics to meet in the consulting room? Does our profession qualify us to make political statements out in the world? The answers involve both risk and reality. By Clare Pointon In the weeks that followed last summer's London bombings, therapists from across the city converged on a meeting room in north London for two events at which they shared feelings, thoughts and ideas – as people and as professionals – about the fall-out. The meetings – organised jointly by the grouping Psychotherapists and Counsellors for Social Responsibility (PCSR), The Confederation for Analytical Psychology and the journal Psychotherapy and Politics International – may not have resulted in any public manifestation on behalf of the profession, but they surely indicated something important about our increasing need to struggle collectively to process our common – and different – responses to breathtaking events in the outside world. According to Andrew Samuels, one of the founders of PCSR in 1995, they also point up the need for a substantial and responsible body of theory and practice on how to work with politics – be it a big event like the London bombings or any other aspect of the external world – when it emerges in the therapy room: 'We're at sea as a profession. We have a lot of desire to do something with this kind of material, but not much notion of what to do,' he says. 'It's a great mistake to split off doing this kind of work with feelings and ideas around political issues only when there's a very big issue, because the political dimension is active all the time and people have very long-held assumptions and theories about politics. So how a person reacts to the London bombings will be no accident.' Samuels, who combines his work as a psychotherapist with work as an academic, activist and writer, has conducted his own survey into the frequency with which colleagues report politics coming up explicitly in sessions. And he believes it's increasing. So, if he's right, why should that be happening? Politics raises its head 'I think there's a much greater recognition that the categories of inside and outside, internal and external, are more provisional and invented than we'd thought,' he says. 'The outer world of politics is clearly coloured and affected by our internal lives. And what we now know is that the internal world is more affected by collective events and processes in the outside world than we'd previously thought. Phenomena like war and migration really penetrate the individual world, which fills up not only from external sources like the family, but also from the society in which the person is living.' Previously neglected theoretically, particularly in schools of thought where the therapist's neutrality was seen as key to the work and early relationships the only important influences, Samuels argues that the political content of our work has in more recent decades also fallen victim to self-censure. Practitioners have more consciously chosen to avoid what might be seen as radical in order to stay on the right side of the institutions on which they depend for the funding of their work and research. He points to the impact on the Encounter Group movement in the United States in the 1960s of what were seen as its revolutionary methods; it failed to secure the financial backing given to other projects run using methods judged to be safer. And even in Britain today, he suggests, the process of statutory regulation would be unlikely to remain unaffected, were the professions of counselling and psychotherapy to engage in collective criticism of areas of government policy. Risks of engaging Psychotherapist, trainer and author Nick Totton argues that practitioners also perceive other – more personal – risks to engaging with politics in the consulting room. One of his particular interests is the way in which, when we allow the external political world to come in, there is a dynamic impact on the internal politics of our relationship with a client. For not only might we find ourselves disagreeing with the client's views – and what, we might ask, would we do then? – but, more generally, in letting in the outside politics, we let go of what he calls the traditionally 'safe seat' of the professional, the place where we have expertise and power, where one person is simply coming for help and the other doing the helping. Yet he believes that letting go of this safe seat may be what is helpful. It is key to his own intersubjective approach in which he says he responds to a client – not just when the client is talking about his intrapsychic issues – but also when he is discussing the Iraq war: 'I believe we need to be willing to reveal something of ourselves and our own place in the world in this relationship, to be another politically-minded person,' he says. 'If someone is bringing in a political experience and we sit mute, that is a political response. There are always two people in the room with views on everything. I try to take away the sense of specialness and the difference attached to overtly political issues. 'My specific interest as a psychotherapist of a client bringing in political material is the way it affects them and their stance in relation to it.' But what about the boundaries, the protection of a client who might be unduly influenced while in the grips of a powerful transference? For Nick Totton, the risks are there, but they're limited: 'I think we often treat the transference as if it's a fragile flower. It's really enormously robust. When it comes to it, it will make what it makes of a situation. If a client needs to see me in a certain way, that is what they'll do, no matter what I offer them.' Working with the political So how can we work more consciously and openly with politics in our sessions with clients? For both Nick Totton and Andrew Samuels, what's most important is conveying our openness to our client's political self, just as we convey our openness to their intellectual, emotional or sexual selves. 'You work with what someone brings,' says Samuels. 'If someone brings a row with their partner the night before, you don't say that you don't want to discuss that, that you want to talk about gender politics or hardwiring. You know, and you convey to them, that there is also a deeper aspect to it that you will gradually share and explore with them.' As far as he's concerned, working with the political is not a matter of heavy-duty political or social constructivist critique; it can be as simple as responding to a client's desire to explore how they want to vote – a single question which, he points out, contains all the deeper questions like: What is politics? What is a good society? Where am I in relation to the community, to the social and political history of my family? But many clients don't introduce this material explicitly, in which case, he says, the therapist needs to be attuned to hear it – perhaps in dreams, perhaps in discussion of workplace issues, an area which can often bridge the world of personal values and those of the organisation, colleagues, the work culture. Sometimes, he says, people don't bring political issues at all, in which case you don't deal with them. However, in Samuels' own view the 'political disorders' are increasingly in the frame, an indication of what he sees as the changing parameters of what can be part of the work. Prominent among these disorders, he believes, is depression and its associated symptoms. He explains his thinking in terms of Object Relations theory: 'Depression is the result of a fantasy that one's anger and destructiveness have actually damaged somebody. In the political world people are angry all the time, so one of the reasons why there seems to be a lot of depression and apathy is not because there's a lot of depression and apathy, but because there's a lot of anger that gets psychodynamically altered into depression and apathy.' Counsellors and psychotherapists, he argues, need to understand that these emotional conditions may have, at root, political causes. So if some of the emotional distress our clients bring has political causes, then therapy can only ever be part of the answer. And for Samuels, the practitioner's role is to help them identify what is at its root. He believes that many middle-class clients may be caught up in depression arising from the fantasy that they are – at least partly – responsible for destroying the planet. Meanwhile others may bring depression arising from major social difficulties – and in these cases, whilst it could be useful to explore their part in it, how they feel and what they want to do about it, their basic need may be for money or practical help. From here, it's only a small step to accept Samuels' argument that we as practitioners have good reason to get involved in bettering our world: 'External events invade the psyche whether they are bad or good,' he says. 'The positive aspect of this is that human nature can be changed by changing the system. I still believe that. You could say that's why psychotherapists have a stake in a better society because it will make for greater psychological ease and happiness.' Political action… Samuels is critical of colleagues who caution against political action on the basis that it is immature and inferior to reflection. In his view, we as a profession are well placed to offer commentary on how our society is affecting the individual. But we need to do this in an efficient way – to follow the rules of academic and scientific communication, form a hypothesis and make an argument. When enough people who have written or spoken on a particular subject then come together, you get a critical mass and from there it's possible to put this kind of message out into the wider world. In his original vision, PCSR was intended to be the vehicle for just those communications. Sometimes, he says, the organisation did this successfully, for example in the 1990s when members successfully lobbied the Government to insist that counselling and psychotherapy trainings did not discriminate against gay men and lesbians. More recently, however, he believes it has failed to be politically active enough. At a wider societal level, he argues, therapists can have a useful input on any committee where there is a panel of expertise – on issues affecting the environment, the economy, even leadership of an organisation or a party. They have specific skills which are relevant to the corporate, organisational and political world in the form of consultancy, something in which he himself is professionally involved. …or sharing process? This is not a view to which Nick Totton subscribes. Whilst highlighting Samuels' important contribution to this subject as a whole, he does not agree that counsellors and therapists have an expertise from which they can advise or even pronounce on political decisions. For him, the only expertise we can offer is the knowledge we have of process and the ways in which that may be relevant to political or even organisational groupings. As a member of PCSR, for example, he says he found 'absurd' its decision to send a message of support for the Good Friday peace agreement in Northern Ireland: 'I don't think we have anything to say on this,' he says. 'For a start, I'm sure that we don't have a unanimous position on it. And this is not our area of expertise. We may have expertise on how to support conflict processes – hopefully we know how to sit in the fire, to bear it. And it seems to me that that's tremendously useful in enabling opposing sides to stay in the same place together. But we don't have expertise on what should be the outcome.' Totton is also against the idea of co-opting practitioners onto external committees as advisors. He sees the role of the therapist in the outside world as a politically active citizen, in the same way as any other citizen. In his view, the two main mistakes we can make in the political arena are either to stay in our professional ivory tower and plead that what happens outside it is nothing to do with us, or to argue that it is and that we know best because we are psychotherapists. His desire is to see therapists, like other citizens, functioning pluralistically – 'forming groups, networking, contributing to a rich political tapestry'. He welcomes the role played by psychotherapists within the ecological movement's debate about why we may be contributing to the demise of our planet, as well as the facilitation by therapists of meetings of groups such as the European Social Forum Movement. He believes in PCSR as a body which can provide an arena of debate and support for practitioners open to thinking about their and their clients' responses to events in the world around them. But he doesn't think it can be helpful to try to come up with a collective political view on behalf of the profession: 'My own political view in general is that we will reach the best results if every point of view has a chance to be heard,' he says. Future scenarios Totton has a sense of pessimism about the future role of the profession out in the wider world. He foresees what he calls 'a drastic split', between those counsellors and psychotherapists on the one hand who practise in the way that many people do now in an involved and individual way, with perhaps a stretch in the future towards what may yet be considered more radical and controversial – and those on the other hand who practise what he calls 'the technological application1 of counselling and psychotherapy. In his view, this second activity – which for him includes work advising governments and corporations – has a sense of selling our 'expertise', perhaps even selling out. For Nick Totton, the profession of psychotherapy, as it was originally conceived via psychoanalysis, can only contribute where the potential outcome remains open. Andrew Samuels, on the other hand, is positive about the changes he believes are in the wind. For him, increasing awareness of the scope for psychotherapy and counselling to integrate and be integrated into the world outside the consulting room is healthy, dynamic and energising. And, he believes, the potential is not limited to the political arena. Closely linked, in his view, is a growing fascination with the relationship between therapy and spirituality, a trend he sees evidenced in the recent proliferation of books on the subject. 'I believe that this is also a spiritual matter,' he says. 'This is about therapy in the wider world, and one wider world is the political one; the other is the spiritual one. I think it's a very exciting time for therapy.' Nick Totton's latest book, The Politics of Psychotherapy:
New Perspectives, is published by the Open University Press. References
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