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Volume 18
Issue 1
February 2007


The idea of democracy is relevant to our inner and outer worlds, our behaviour as world citizens, our client work – even the process of regulation

  • Democracy and therapy

  • by

  • Nick Totton
  • I expect that some readers will be surprised and puzzled by the combination of these two ideas, democracy and therapy. What do they have to do with each other? Quite a lot, I want to suggest – but to explore how therapy connects to democracy (and vice versa) I first need to look at the concept of democracy itself.

    Democracy is now quite a hot potato. It has become the rallying cry for many different, and often opposing, points of view. Everywhere, there are struggles around the issue of democracy – what it means, how it works, what it’s worth. George Bush and Tony Blair want to create democracy throughout the world – by force, if necessary. This raises two tricky questions: first of all, can democracy be established at gunpoint, or is this a contradiction in terms? And secondly, is what we have in the UK and the USA really democracy – is it, as Bush and Blair claim, the gold standard by which all other political systems should be measured?

    What we have in the UK is representative democracy. More technically, it employs ‘free representation’; this means that we elect individuals who are then free to do whatever they (or their parties) wish. Our only control over them is the possibility of throwing them out at the next election. Until recently, parties held their election manifesto sacrosanct, since this was the agenda on which we voted; this at least paid lip service to the idea that it is the people who decide. Increasingly, however, New Labour feels free to go against its manifesto and bring in policies different from those it promised.

    All of this is obviously a long way from people having control over the fabric of their lives (‘demo-cracy’ means ‘people power’). How much say do any of us have in how our taxes are spent? How our workplace is organised? What happens in our locality? Or when ‘our’ government goes to war? Certainly we can make our opinions known – this is a very important freedom – but no one is obliged to pay any attention. Increasingly, it seems, a sense of powerlessness and alienation from the political process is turning people away from exercising the rights we do have – even the right to vote.

    Our contribution
    So, again, what does this have to do with therapy? Well, therapists working with groups have a great deal of experience in attending to all of the viewpoints which are present in the group – even unconsciously held ones – and bringing them into dialogue with each other. In fact, there are many facilitators around the world working in global ‘hotspots’ on issues of conflict and reconciliation, bringing together members of hostile communities – Palestinians and Israelis, Serbs and Croats, Irish Catholics and Protestants – and finding ways for them to recognise their shared humanity and start to communicate1. A set of skills and understandings is being established here which, it seems to me, could be an enormous resource for supporting direct democracy, rather than representative democracy – a state of affairs in which no one needs to be represented, because every voice and viewpoint is fully present.

    This is what the well-known psychotherapist Arnold Mindell calls ‘deep democracy’, which, he says, rests on ‘that special feeling of belief in the inherent importance of all parts of ourselves and all viewpoints in the world around us’2. As Mindell emphasises, deep democracy is an ancient and universal concept and experience; it is surely also central to what therapy is all about, both with individuals and with groups. Perhaps, then, we have something to offer the wider world as it struggles to deepen democracy on every level, to move from ‘majority rule’ – or even ‘money/power rule’ – to control over our own lives. This struggle seems to me even more urgent in the light of the ecological crisis and the threat of climate change: not only do governments need to listen to their peoples, but human beings need to listen to the voices and needs of other species and the whole planetary ecosystem: deep democracy means deep ecology3.

    At the same time, though, issues of democracy hit home within the world of therapy and counselling . The government is currently seeking to impose regulation through the Health Professions Council, with little consultation of practitioners; or rather, we are being asked for our views on the details of the arrangements – exactly what ‘competences’ should be ascribed to therapy and counselling – but not whether this is the right way to proceed with regulation; and certainly not whether state regulation should happen at all. Is this democracy? (You can read the consultation paper from Skills for Health at under ‘Regulation’).

    The large professional organisations for psychological therapies are starting to protest about the Government’s plans; but only because these have turned out to be different from their own plans for state regulation, which they were equally willing to impose without real consultation. Perhaps these organisations might now want to reconsider on what basis they claim to ‘represent’ their members. This is particularly glaring in the case of UKCP, which up to now has not even had individual membership available, while still claiming to somehow ‘represent’ practitioners. But to what extent do the policy decisions even of BACP actually derive from the views and wishes of its members? There is at least a debate to be had here about how therapy and counselling should organise themselves – and whether we shouldn’t do this on the basis of what we know as practitioners about people and groups, rather than leaving many of our skills and understandings at the door of the meeting. Increasingly, we are being ‘represented’ by people who are not even practitioners themselves.

    Power in the therapy room
    I may be stepping on some toes already, but I’m afraid I need to go even further – democracy, taken seriously, is a powerful solvent! I want to explore how democratic our practice itself is. Within the therapy room, who decides what is true and what is false, what is ‘real’ and what is ‘illusion’? Practitioners have a great deal of power to control how things are interpreted, and they very often use it. As Anna Sands points out: ‘Psychotherapy is the only profession where the practitioner can be insensitive, evasive, patronising, arrogant, discourteous, self-righteous or just plain wrong, and where clients’ observations of this can be taken to be an expression of their problems, evidence that what they really need is more of the same therapy.’4

    Dave Mearns and Brian Thorne suggest that, as therapist and client start off working together, ‘the counsellor holds nearly all the cards in a game of which the client does not even know the rules’5. So, is genuinely informed consent to psychotherapy possible, when no one can appreciate in advance what it will be like, however much it is explained to them?6 Even when the client learns the rules, these are not the client’s rules, but those of the practitioner, or of the therapy ‘game’ itself. In the therapy or counselling room, practitioner and client each have exactly one vote on what is ‘really’ happening; each has a wide range of techniques available to influence the other person’s vote, to encourage them to see it ‘our’ way – but in many ways the balance is weighted towards the practitioner as expert. In this context, very early wounds around power, autonomy and validation can be re-experienced. If well handled, these wounds can be transformed; if mishandled, they can be reinforced. The most obvious way for practitioners to mishandle the situation is to claim that our expertise, our wisdom, our insight into the human heart, entitles us to an extra vote. Unfortunately this is no more true in a therapy relationship than it is in a parliamentary election7.

    Readers may be starting to feel anxious and defensive by this point. I share this feeling. After all, like you, I know that I am a reasonably ethical person, with (conscious) good intentions; yet by its structure, therapy can often feel to clients like a ‘no win’ situation, where someone else always holds the better cards. Rather than trying in vain to eliminate the power struggle from the therapeutic relationship, my suggestion is that we position it centrally, highlighting the struggle between therapist and client over the definition of reality and making it a core theme of our work. Therapy can then be seen as a joint achievement of real power-sharing.

    Inner democracy
    A further interface between the political and psychological is the idea of inner democracy. Is our internal landscape ruled by a totalitarian dictatorship? Or are the different, often contradictory elements of our plural personalities given space to express themselves? Many forms of psychological practice pay attention to the different ‘parts’ of each person’s psyche – for example, inner critic, inner child, inner teacher – and to the need for these parts to come together and reconcile their different needs and attitudes. This work of tolerating and negotiating with inner difference both encourages us to take a more tolerant and receptive attitude towards outer difference, and equips us to do so – we are less likely to project unwanted parts of ourselves onto other people whom we then attack.

    As we have seen, Arnold Mindell2 emphasises that deep democracy operates on both external and internal levels, and asserts ‘the inherent importance of all parts of ourselves and all viewpoints in the world around us’. In 2004, Hal and Sidra Stone, the founders of the Voice Dialogue method for working with subpersonalities, published an open letter to George W Bush, in which they pleaded with him to consult his inner community in the hope that this might influence his policy on Iraq: ‘Our deepest concern … is not the Saddam Hussein that lives in the world. Our deepest concern is the Saddam Hussein that lives in the hidden recesses of your own heart, of our heart, of everyone’s heart. If we don’t recognise that this kind of energy lives in each of us, we keep projecting it onto the outer Husseins, and that makes it impossible to deal with the darkness in the world in any way other than war.’8

    As they indeed recognise, this is a pretty hopeless appeal. One of the most depressing things I know about George Bush is that, according to his ex-Treasury Secretary, Paul O’Neill, one of the President’s favourite maxims is ‘I won’t negotiate with myself’9.

    Deepening democracy
    Negotiating with ourselves, however, is what we all need to do; and what therapy helps us to do. In doing so, as the Stones make clear, therapy is furthering democracy in the outer world as well as the inner – because these two are not separate but in constant dynamic interaction through mechanisms of projection, introjection and identification. ‘Deep democracy is our sense that the world is here to help us become our entire selves, and that we are here to help the world become whole.’2

    Few people would deny that the world is currently in crisis. Perhaps the world is always in crisis! In any case, this ongoing crisis calls for a response from us – as citizens, and also as therapists. As therapists, we certainly don’t have the answers; we don’t even have the answers for our clients, which, as I have argued, is an inherently undemocratic and also unhelpful notion. But we do have some good questions, and some good techniques for enabling everyone and every viewpoint to be heard. In their book Multitude, Michael Hardt and Antonio Negri argue that globalisation, while in some very obvious ways attacking democratic freedoms, also establishes the conditions for a new and more radical expression of democracy, based on pluralism and selfmanagement. ‘Every sign of the corruption of power and every crisis of democratic representation, on all levels of the global hierarchy, is confronted by a democratic will to power. This world of rage and love is the real foundation on which the constituent power of the multitude rests.’10 Rage and love? That sounds like our territory!

  • Nick Totton is a body psychotherapist and trainer in private practice. Website: Contact:

    Democracy and Therapeutic Practice: ‘People Power’ in the Intersecting Worlds of Psychopractice and Politics. Independent Practitioners Network National Conference at Roehampton University, 31 March to 1 April 2007. Presenters: Arlene Audergon, Denis Postle, Andrew Samuels. Workshops and whole-group process. Details available from:, or by phoning 01422 886525.

  • References:

    1. Audergon A. The war hotel: psychological dynamics in violent conflict. London: Whurr; 2005.
    2. Mindell A. The leader as martial artist. Portland, OR: Lao Tse Press; 1992.
    3. Totton N. Wild at heart: another side of ecopsychology. Therapy Today. 2005; 16(10):18-21.
    4. Sands A. Falling for therapy. London: Macmillan; 2003.
    5. Mearns D, Thorne B. Person-centred counselling in action. London: Sage; 1988.
    6. Hinshelwood RD. Therapy or coercion? London: Karnac; 1997.
    7. Totton N. Power in the therapeutic relationship. In: Totton N. (ed) The politics of psychotherapy. Maidenhead: Open University Press; 2006.
    8. Stone H, Stone S. An open letter to the President. Psychotherapy and Politics International. 2004; 2(1):64-9.
    9. Powers T. Tomorrow the world. New York Review of Books. 11 March 2004.
    10. Hardt M, Negri A. Multitude: war and democracy in the age of empire. London: Penguin; 2006.

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