SCoPEd: Denial, Distortion & Deception

The British Association for Counselling & Psychotherapy (BACP), the British Psychoanalytic Council (BPC) and the United Kingdom Council for Psychotherapy (UKCP) – collaborating under the banner of the SCoPEd (Scope of Practice & Education) project – recently published a draft ‘competence framework’, which attempts to differentiate counselling and psychotherapy.

Andy Rogers (BACP member and counselling service coordinator in further and higher education for two decades) submitted the following response to BACP’s consultation survey.


 

It is astonishing that the SCoPEd project claims this document will improve clarity for clients, employers, trainers and other stakeholders. I can only assume the competence framework exists for other political purposes, because there is certainly no clarity here, which might be forgivable if the document was at least more truthful.

But, as one of a number examples of the confused (unintentional?) deceptions in this framework, it is completely erroneous to identify 3.5.c (Ability to negotiate issues of power and authority experienced in the inner and outer world of the client or patient as part of the therapeutic process) as a ‘psychotherapist’ competency (one therefore presumably not held by mere ‘counsellors’), when for any person-centred counsellor worth their salt, this would be a central principle of everything they do! The same could be said of another ‘psychotherapist’ competency, 5.1.c. (Ability to evidence reflexivity, self-awareness and the therapeutic use of self to work at depth in the therapeutic relationship and the therapeutic process).

These examples demonstrate how formal differentiation between the adopted titles often means the imposition of something (i.e. simplistic, hierarchical separation and compartmentalisation) that isn’t actually there in practice among the human beings entering into therapy as practitioners and clients. In reality, there is much fluidity and complexity, which the framework attempts to iron out by positioning psychotherapists as doing the really deep stuff, counsellors as merely dabbling, and then a mysterious in-between group that does more than the basic counsellors but isn’t quite at the psychotherapist level.

“it is not the practitioner’s title that determines what happens in the therapy relationship.”

As most of us know, these levels – assumed in the document to be clear-cut enough to be separated into columns and boxes – are manufactured. At best they are only partially truthful, some of the time, in some situations, for some individuals. They certainly do not accurately represent the field, within which many practitioners who identify as counsellors will see their day-to-day work in the ‘psychotherapist’ column; while there will be plenty of ‘psychotherapists’ who have not yet developed the depth of practice (if we describe it that way) of some ‘counsellors’. After all, it is not the practitioner’s title that determines what happens in the therapy relationship.

That we end up working under one label and not the other is subject to all sorts of choices, influences, values, historical precedents and contextual factors, and often says little to nothing about what the experience of therapy will be like for clients, which could be vastly different between any two ‘psychotherapists’ or any two ‘counsellors’. For a whole swathe of the field, such as the humanistic section – and particularly in person-centred therapy – there is no distinction at all made between ‘counselling’ and ‘psychotherapy’ in terms of the actual work (which this framework purports to articulate); the different titles merely refer to the traditions and histories of various training programmes, professional organisations/groupings and work contexts (and the job titles therein).

“When did therapists become so uncritically disengaged from the roles of history and power in the narratives we hold about ourselves?”

The therapy field is a diverse and complex ecology, which, rather than celebrate, the framework appears to want to eliminate by reasserting hierarchies that are well past their use-by date. A historical aside here is that counselling as an alternative word for psychotherapy has roots in Carl Rogers’ mid-twentieth century tactical switch from the latter to the former at the University of Chicago, which was necessitated by a law that ‘psychotherapy’ could only be practiced by medical professionals. From the very beginning of ‘counselling’, then, the different words were not functional descriptors of differing activities, roles or levels of ‘competence’, depth, ability, skill or experience but were value-laden, politically charged and subject to the operation of power and professional (self-)interest. This is no less true today, but the SCoPEd project is in complete denial about it. When did therapists become so uncritically disengaged from the roles of history and power in the narratives we hold about ourselves?!

It’s notable in sections of the framework that ‘psychotherapist’ is apparently equated with greater alignment with psychoanalytic theory. Is the field not done yet with this power struggle, with the idea that psychoanalytic theory sits at the top of a hierarchy? The ‘note on terminology’ almost acknowledges this tension but concludes, absurdly, “Where terminology has been used that could be interpreted as being modality-specific, this is not the intention.” Oh, that’s okay then – it’s the thought that counts, eh? Being ‘expert’ therapists, I thought the Expert Reference Group (ERG) might have a bit more to say about the importance of language and the power that runs through it, looking beyond stated intentions towards the deeper meanings and influences when we choose one way of saying something over another (especially in a potentially influential document such as this). No?

I was also wondering how this apparent pro-psychoanalytic bias – with its implicit discrediting and delegitimising of humanistic/existential/person-centred counselling/psychotherapy (and their associated values, not least around language) – came about. Then I noticed the ERG was made up of 12 practitioners, 7 of whom were identified as psychoanalytic, whereas only 1 was clearly identified as humanistic (and even then, only as part of an ‘integrative’ model) (see pp.72-73 of the SCoPEd Methodology document). How can the framework produce an accurate picture of the field, when the ERG does not represent the diversity within it?

But the whole project is also skewed by other assumptions and value systems around therapy, which are perhaps even more important for the future of our professions. The Roth/Pilling UCL methodology used here was developed originally by manualised CBT proponents for the CBT competence framework, which was commissioned by the Department of Health as part of IAPT’s development. As this history suggests, breaking down the relational art of therapeutic work into lists of discrete ‘competences’ is not a neutral or objective activity (however ‘evidence-based’ it disingenuously claims to be); it is a technocratic pursuit that clearly derives from the NHS-appeasing assumption that therapy can be manualised into specific skills that, if applied in accordance with the manual, provide ‘effective’ ‘treatment’ for specific ‘disorders’. In other words, the project inevitably – via its very form – aligns therapy with an instrumental and medicalised healthcare model, again potentially delegitimising approaches that see therapy as, say, a meaning-making dialogical encounter or principled way of being.

That none of these biases or agendas, and the political expediency from which they spring, are acknowledged in the framework, highlights its failure to take a therapeutically informed, self-reflective, critical thinking approach to its own motivations, intentions, guiding principles, methodology or articulation. Presumably none of this matters much if your goal is to air-brush the imperfect, fallible, human complexity of relational therapeutic work, in order to prepare for the distribution of power that statutory regulation would involve for the organisations that have composed this empty but highly potent document.

andyrogerscounselling.com

@AndyCounsellor

 


 

 

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‘Psychoanalytic coup’ – Andrew Samuels on the SCoPEd Competence Framework

Sent to the Chairs and CEOs of BACP, UKCP and BPC

January 24th 2019

From Professor Andrew Samuels


You have every right to ignore this.

I was in the room as chair of UKCP when the HPC Professional Liaison group in 2010 were told by Prof Peter Fonagy that counselling was inferior to psychotherapy. BACP (Sally Aldridge) were apoplectic. But now, when I look at the lists of competences, I feel sure that many counsellors meet those ascribed to psychotherapy. I’ve trained some of them.

(Incidentally, didn’t the abject failure of the Skills for Health competency based project stick in anyone’s memories?)

Moreover, the interests of Jungian analysis, body psychotherapy, arts psychotherapies and transpersonal psychotherapy have been downplayed. I am not sure how a humanistic and integrative psychotherapist might react, to be honest. Not well, I surmise.

What has happened is that psychoanalysis and psychoanalytic psychotherapy have pulled off a major coup. Their values and approaches have triumphed. I am sure that this will be widely recognised by anyone who reads the documents. It reflects the dynamism and skill of their top people, in my view, so hats off to them in a way!

I have returned the survey to BPC and UKCP. In the free section, I have expressed astonishment that the discredited work done by Roth and Pilling in different contexts has been utilised in this one. Those academics are gung-ho for NICE, IAPT and statutory regulation. They are not friends of the work that we do.

The whole thing strikes me as an example of fiddling while Rome burns. Actually, it is worse than that. We’ve spent decades making sure that, for example, job adverts ask for BACP or UKCP or BPC membership where once the BPS held sway. I’ve been proud to be a part of that. We even managed to reduce the stress on modality in most adverts, except those where the consultant doctors were psychoanalysts. We have begun to get the Professional Standards Authority on the map.

Now three utterly bizarre neologisms are being put forward. And this is going to make getting jobs easier? Or help applicants? ‘Qualified counsellor’, ‘advanced qualified counsellor’, ‘psychotherapist’.

Even if the old terms are restored once the survey has run its course, the discrepant crunch between the two indicative languages will be so confusing.

And what is the point of saying that these terms are ‘loosely described’? They are not loosely described at all; they are clearly differentiated (albeit on shaky grounds) and formed into a tendentious hierarchy.

Sorry for the passionate way in which I write. I am hoping that there will be massive opposition to these proposals but am realistic: the supine memberships mostly won’t bother about it at all – a few will support, a few will oppose, and we shall lumber on, promoting the demise of depth, relational work – what I still call (semi-seriously) ‘real psychotherapy’.

Finally, I will comment on page 72 of the main document where the membership of your Expert Reference Group is given. There are 12 in total, 7 of which are psychoanalytic, 2 integrative (unspecified combination), 1 hypno-psychotherapy, 1 pluralistic (unspecified combination) and 1 humanistic-integrative. Add in the chair and information analyst and I believe it comes to 8 psychoanalytic and 6 others (of which only two are explicitly humanistic in orientation).

How is this a balanced group of experts??

 

 

 

 

 

 

Regulation, professionalism and cultures of dominance

The government has published a consultation document, Promoting Professionalism, Reforming Regulation. Although the paper does not mention counselling and psychotherapy directly, it does ask questions of, and propose changes to, the current system under which registers of counsellors and psychotherapists are accredited by the Professional Standards Authority (PSA).

In 2011, the Alliance cautiously welcomed the PSA system as an alternative to an earlier proposal to regulate counsellors and psychotherapists under the Health & Care Professions Council (HCPC), a plan we – and thousands of other practitioners – strongly opposed.

As we start to make sense of the current discussions, in which some in our field are already pushing again for state regulation while seeking to further align therapeutic practice with healthcare, we share as food for thought one submission to the consultation from long-term regulation-watcher and Alliance participant, Denis Postle.


Promoting Professionalism, Reforming Regulation: Consultation Submission from Denis Postle, ARCA

January 20, 2018

“How could the dominance cultures of the professional psychological organisations, however well intentioned, make reliable, just adjudications of the dominance misbehaviour of alleged errant members?”

I have been a practitioner of group facilitation, personal development training and therapy in the Humanistic Psychology and Human Potential traditions since 1985. In 1995 I was a founder participant of the Independent Practitioners Network (IPN) and for me this continues to be a dynamic way of sustaining practitioner civic accountability. This is not an Independent Practitioners Network response.

Over the last 20 years I have taken a detailed and sustained interest in the ongoing processes of regulation of the psychological therapies, publishing a considerable  amount of material on the internet via eipnosis: a journal for the Independent Practitioners Network  and two books, plus participation in several others.

As I will outline below, the more I saw of mainstream counselling and psychotherapy institutions in this time, the less I was inclined to be associated with them; this perspective is thus of an outlier. IPN emerged as a response to what was perceived as inadequate forms of civic accountability in the psychological therapies.

2.2  ………As the HCPC has traditionally been the regulatory body to assume regulatory oversight of new groups, it could be seen to have a vested interest in expanding its registrant base. We therefore believe that the PSA, working with relevant stakeholders, would be better placed to provide advice on the regulation of professions

During the abortive process of taking counselling and psychotherapy into regulation by the HCPC, then just HPC, I had extensive contact with its chief executive, Marc Seale, and attended and reported on a substantial number of events and meetings there. I became convinced that, then or now, for the HCPC to regulate psychotherapy and counselling would be as inappropriate as putting the Royal Ballet under the control of the Sandhurst military academy. The HCPC knew how to ‘grasp’ but had no capacity for ‘holding’ the nuances of the practice of counselling and psychotherapy. Happily the HCPC’s coercive, prescriptive approach to this task failed and should not be revived.

I attended many of the early foundation meetings of the PSA and its cultural grasp of regulatory tasks was notable for its more participative, cooperative stance.  I regard it as a least worst option.

Promoting professionalism, reforming regulation

The text of the departmental statement under this headline, as so often, appears to make a presumption that psychotherapy and counselling are some subsidiary of medicine, i.e. they consist of ‘assessment’, followed by ‘diagnosis’ and ‘treatment’ of ‘patients’. This hegemony of the medical paradigm and the assumption that how medicine is regulated can transfer to the psychological professions continues to defy constant challenge from critical practitioners. It is perhaps a key vehicle through which harm to people in need continues to be enacted.

There may be a small place in the diverse cornucopia of the psychological therapies for biomedical treatment using zero responsibility elixirs but the overwhelming basis of psychological work is relationship. This means that there is an intrinsic element of risk, and insofar as  regulation has sought to make this disappear, it has tended to make professional practice defensive. How can this be in the public interest?

Risk can and should be minimised, to do this successfully would seem to  mean there was comprehensive evidence of the actual amount of harm that was prevalent in the psychological therapies. I and colleagues I have consulted are not aware of any such evidence.

Witnessing the regulatory shenanigans over the last 20 years in the UK convinced me that ‘Professionalism’ in the psychological therapies is comprehensively compromised in ways that this consultation seems unaware of.

Some perspectives that may be relevant:

The psychological therapies can be seen as an extractive industry. Practitioners work with clients, they accumulate in professional journals the insights that emerge; there is parallel input to trainings, supervision and professional conferences, where the extracted knowledge is refined  and fed back into practice. This tends to be a self-referential elite activity, the psychological knowledge does not diffuse significantly into society. One result of this elite grasp of work with the human condition amplified by the pathologising of instances of common human distress, has been the generation of stigma. As a result, and especially in the current climate of economic ‘austerity’, access to professional psychological knowledge typically requires a crisis.

For the industrialised psychological therapies, regulation has multiple benefits. It supports the creation of professional walled gardens of therapeutic practice membership of which is restricted in ways that generate unnecessary scarcity. The walled gardens are also professionally and economically in competition with each other and have often seemed more concerned with status and protection of the profession than of enriching and empowering the population at large.

Due perhaps to the medical paradigm that shaped early development but also because of an overly self-referential professional culture, access to these professional walled-gardens tends to be excessively expensive, unduly lengthy and with inappropriately complex academic content. Where is the evidence that, apart from the economic benefits to universities and training institutes, and enhanced professional status, a Masters or a PhD is a requisite education path for sitting alongside people who are struggling with human condition difficulties?

2.9  ……….In addition, the Law Commissions recommended that regulatory bodies be given powers to operate a form of negative register through the use of prohibition orders for those groups not subject to statutory regulation. Such a scheme allows individuals to be barred from practising a specified profession or from carrying out specific activities and would set the standards required of a certain occupation. Where these standards were not met in a way that places the public at risk of harm, the relevant regulatory body would issue a prohibition order that would prevent or restrict an individual from carrying out a certain role or providing certain services.

This is perhaps the most important issue of the consultation.

I see no problem with a person convicted by a court of abuse or fraud being included on a public register of such offenders. The key to this is ‘convicted by a court’.

Inclusion on such a list of people found guilty of abuse by the professional bodies that are presently under the wing of the PSA would be unacceptable.

Three reasons for this:

1. In my experience of the behaviour of some people in the psychological professions, there will likely be a witchhunt of practitioners like myself who are on, or just outside, the margins of the regulation regime. Or for instance, who belong as I do, to civic accountability bodies that are too small for the PSA’s attention.

2. My study of the UK psychological professional bodies, including the HCPC, constantly demonstrated a profound paradox. The bodies claim to be protecting the public from abuse. But what is the origin of abuse? It is the enactment of some form of physical, emotional or cognitive dominance behaviour, i.e. some form of coercion, bullying or sexual abuse, due, leaving aside mistakes, to an unworked thread of belief or behaviour in the practitioner that licences them to enact some form of domination.

Why does this matter? It matters because with no exception that I know of, the professional psychological bodies associated with the PSA are all structured as traditional top down dominance cultures in which executives make decisions on behalf of members.

How could such dominance cultures, however well intentioned, make reliable, just adjudications of the dominance misbehaviour of alleged errant members? Especially if they are licensed to enact extreme dominance behaviour such as legally enforceable negative prohibition orders.

3. A negative prohibition order is way too close to potential abrogation of human rights, i.e. the human right to have a conversation with a consenting Other, paid or unpaid. In the hundreds of modes of approach to working with the wildernesses of the human condition, there will always be people and institutions who find some other approaches to be anathema or alien, and worthy of being dismissed as charlatanism. If they are introduced at all, negative prohibition orders should only apply to convictions by the courts.


Brief references

Books

Postle, D. (2007) Regulating the Psychological Therapies: From Taxonomy to Taxidermy. Ross-on-Wye: PCCS Books.

Postle, D. (2012) Therapy Futures: Obstacles and Opportunities. Lulu.com

Videos

The PsyCommons – Ordinary Wisdom and Shared Power

Around 75% of the UK population have no need of ‘mental health’ services. What is it they know and do that keeps them psysavvy? The psyCommons examines the ordinary wisdom and shared power hidden from us by the mental illness industries and the medicalization of ordinary human distress.

The psyCommons and its Enclosures: Professionalized Wisdom and the Abuse of Power

The second in a series of videos about the psyCommons looks at how the basic human capacity to resolve and survive the ordinary difficulties of daily life through family, friends and local communities, is undermined by the psychological professions, along with their pharma allies.

 

How do we get mental wealth?

In his address to a Labour Party conference fringe event, Paul Atkinson examines the social and political forces at work in our society’s current approach to psychological distress and asks what we need from a new government to support and nourish the nation’s mental wealth.


For whatever reasons – reasons that I think are very important and need to be explored – the emotional and psychological difficulties of living in this society are becoming increasingly visible and alarming: in our families; in our schools and colleges; in our local communities; in the attention drawn to mental ill health by (social) media, charities and celebrities, as well as politicians and social policy makers.

Should we think of this growing attention to mental health and the emotional conditions of contemporary life as a sign of growing awareness of the pain and suffering that has always been with us, hidden away in the private closet of social stigma and shame? Or are we witnessing the symptoms of an increasingly dysfunctional, disturbed and disturbing political and social structure? However we interpret it, I think we can say that there is something very, very wrong. It has either always been wrong, or over the last two to three decades we have been getting something very wrong. Certainly both Tory and Labour governments have been getting something very wrong, and are continuing to get it wrong.

To my way of thinking, there is something very wrong with a political economy which simply carries on, blindly it seems, propagating and prioritising the same fundamentally alienating and corrosive values:

economic growth before all else;

the accumulation of status and worth through money, wealth and conspicuous consumption;

generating and acquiescing in deep inequalities of material wellbeing and of the opportunities to make creative, satisfying lives.

To my libertarian socialist mind, capitalism has always generated toxic side effects in its exploitation of people’s mental wealth – in the service of profit and the accumulation of the few. Neoliberal capitalism – its extractive and kleptocratic offspring – seems to be generating an accelerating pandemic of fear, insecurity and anxiety which is splintering and dividing us as communities and individuals.

So my message to the Labour Party is that we need a government that is prepared to redefine what society is for, who society is for. A government that acknowledges the priority of people’s emotional and spiritual lives, their relationships, their need to give and receive care, support and love from each other. We need a government that is prepared to put our mental wealth before our economic wealth.

Yes mental health services need more money, far more money and human resources. But better funding alone is not the answer.

I am not a mental health service user or survivor of the psychiatric system. I am not poor, black or gay. But let me give you an example from my professional world in which I can claim some small expertise by experience. Let me give an example of how more of the same as far as mental health funding is really not the answer; an example of how what seems like a major step for improving the nation’s mental health is turning out to be as much part of the problem as part of the answer.

In an article in the New York Times in July 2017, titled Englands Mental Health Experiment: No-Cost Talk Therapy, Benedict Carey – US journalistcelebrated as a globally inspiring initiative the UK’s programme of short courses of cognitive behavioural therapy (CBT) in every primary care service in England – the Improving access to Psychological Therapies (IAPT) programme:

‘England is in the midst of a unique national experiment, the worlds most ambitious effort to treat depression, anxiety and other common mental illnesses.’

Colleagues and I on the left of the psychotherapy profession groaned in despair.

In 2008, Richard Layard and David Clark persuaded the Blair government to roll out an ambitious programme of CBT, offering psychological therapy for one million referrals a year through GPs. Layard, an economist specialising in unemployment and welfare to workfare policies, argued that mental ill health was the primary burden on the welfare budget of unemployed people receiving Employment and Support Allowance, and psychological therapy provided by the state would pay for itself by getting people off benefits.

On the face of it, it has been a huge success. Its champions call it the ‘IAPT revolution’. Every CCG in England offers psychological therapy under IAPT. Roughly 1.3 million referrals (some self referrals) were made to IAPT last year. It claims a 45% recovery rate. People in therapy that otherwise would never see therapy.

In reality…

Despite its value to probably many thousands of clients, the reality of NHS psychological therapy is far from the rosy picture Benedict Carey or its champions paint:

At an operational level, IAPT is an assembly line mental health fix.

Of the 1.3 million referrals last year, one third actually finished a course of treatment. In the end, only 12% of all referrals “recover”.

Almost half of these received what is called low-intensity (LI) treatment – something most psychotherapists would not recognise as talking therapy. For example, the most successful LI “therapy” was through non-guided self-help books.

The average number of sessions for all IAPT treatments is nine. A fifth consist of just two sessions. Recovery rates are falling, and the number of patients returning for repeat treatment is growing.

Almost all state funded talking therapy is now CBT, which has replaced virtually all other kinds of psychotherapy previously available free on the NHS.

The gold-standard evidence base for IAPT, based on random control trials, is in fact an avalanche of statistics highly manipulated towards maintaining state funding. Waiting lists are growing. Recovery rates within more deprived areas of England are significantly lower than in wealthier communities.

Meanwhile, according to a recent report by the British Psychological Society, the mental health of IAPT therapists and psychological practitioners is suffering a monumental nose-dive – 50% suffering depression, anxiety and acute work stress.

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And yet, for the moment at least, there seems to be little recognition at government level that something is amiss – the programme is expanding. IAPT is doing an important political job. As far as I and my fellow campaigners are concerned, that political job looks like this:

First, IAPT has no brief, no money and no time to be thinking about the causes and meaning of the mental health issues it is managing. It deals with symptoms on an individual basis and aims to get people back into their everyday “normal” lives as quickly and cheaply as possible. As far as I can see it has no interest in the social model of mental health or in the influence it might have on getting government to think about the emotional impact of economic and social policy generally.

Second, I think of IAPT as a partner of Big Pharma in the growing mental health/happiness industry. CBT with its tick-box inventories, like the mass consumption of anti-depressants, has grown rapidly since the end of the 1970s. They are both contemporaries of the neoliberal turn. IAPT therapy is essentially courses of positive thinking, encouraging you to take more responsibility for your states of mind and adapting a little more flexibly to the realities of the world you are in – including of course the world’s markets.

Third, like antidepressants and other psychotropic drugs, IAPT is administered from the top down, on the medical model of diagnosis and allocation of treatment by a health professional. While the client hopefully has a say in the content of a talking therapy session, she has little say in who she works with, in what kind of setting, with what kind of frame, for how long and so on. If you want a choice of psychotherapy approaches, if you want a therapeutic relationship that is on-going and open-ended, led by your own sense of need, pain and distress, then it’s private practice at £60 – £90 a session.

Fourth. IAPT is an NHS service, state funded and state led. Its basic brief is to get people back into the flow of a “normal” life as quickly and cheaply as possible. This has always included getting people back to work. From its inception, IAPT has occupied and helped create a space in which the government’s policies on mental health, employment and welfare meet up within the toxic framework of workfare, cutting welfare, maintaining a low wage labour market.

“psy professionals have allowed themselves to be drawn in to a system of psychocoercion”

What we as psy workers have been witnessing, as New Labour’s workfare iniatives have progressively developed into the Tories’ vicious – yes, murderous – attacks on people with mental and physical disabilities and on welfare provision generally, is that psychotherapists, psychologists, occupational therapists and mental health workers have been increasingly drawn in – and have allowed themselves to be drawn in – to a system of psychocoercion of people on welfare benefits, a system which glorifies work as the ultimate goal and obligation of citizenry.

As we know, the experience of many claimants with mental health difficulties is one of being terrorised by benefit cuts (whether in work or not), sanctions, fitness to work assessments, PIP, and now the further cuts of Universal Credit. For many, being driven off benefits is not into work: it is onto the streets, into the food banks, into an early grave through ill health, addiction, self harm and tragically, suicide.

The New Savoy Conference, IAPT bosses’ annual trade conference, welcomed with open arms the Tories’ welfare to work policies and the opportunities they offered for state funded therapy to get involved in “helping” people get off benefits and into work.

When George Osborne announced in his spring budget 2015 that he was co-locating teams of IAPT therapists in Jobcentres, that DWP employment coaches were going to be located in GP surgeries and at one point in food banks, finally some of us psy professionals woke up and realised our own professions were becoming agents of psychological terror. That our professions were allowing themselves to be drawn into the violence that is at the heart of the neoliberal project. We got together in 2015 and formed the campaigning alliance that organised this meeting.

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So, coming back to the question, what do we want from a radical Labour Party and Labour government to support and nourish the nation’s mental wealth?

Looking at this year’s Labour Manifesto:

Do I think it’s enough to talk about restoring Tory cuts to mental health services, putting more resources into attending to children and young people mental health, reasserting the need for parity of esteem with physical health, and offering a wider choice of therapy options under NICE guidelines?

Do I think it’s enough to restore Tory cuts to ESA, get rid of sanctions, the bedroom tax, WCA and PIP assessments, to talk about support and care for people who cannot work, and the social model of disability – or even Universal Basic Income?

Well, no.

Of course mental health services need more resources. The hypocrisy of every party declaring their distress at the lack of such services while doing bugger all except to cut funding further is shocking. The only way of understanding this is that mental illness is still regarded as a shameful, frightening shadow of our culture which politicians can get away with ignoring and attacking, as they do with welfare claimants.

Yes, we need more safe spaces for people with acute and severe mental health problems. We will continue to need more people with specialist trainings. And yes we need more talking therapy without a doubt.

But, FIRSTLY we need these services as part of a very different understanding of the kind of society and the kind of relationships that promote and support our mental wealth. Most of what gets called mental ill health is facilitated by the social, cultural and emotional conditions people are living in from day to day, and the conditions we have been in most of their lives.

We need housing policies, education and early years policies, transport policies, policies on working conditions, as well as health policies, that give the first priority to how people feel about themselves and their world, not to how they can be managed to maximise GDP.

And SECONDLY, absolutely crucially, if we are going to take seriously the priority of mental over material wealth at all, we need a society in which people feel that they not only have a say in how their world is developed and run; we need a society in which people feel they have THE say, the FIRST and LAST say, day to day, in how their world is organised.

Top down mental health services, administered by psychiatrists, psychologists, therapists, nurses and other professionals disempower and isolate individuals as mental health problems. To as high degree as possible these services need to be designed, managed and developed by service users and survivors. Professional services need to be in service, really in service, not driven by their own managerial ambitions, their profit making, or the fear of hanging on to an impossible job.

“Work remains the absolutely critical structure of social control in these capitalist societies of ours.”

For how long are we going to carry on preaching and believing in the insanity of the capitalist work ethic? That your value as a citizen is dictated by having a job? That it is your obligation to society to be in waged work? Are we absolutely bonkers?

Only 13% of people worldwide actually like going to work, according to a Gallup poll conducted in the States and published in the Washington Post October 10th 2013. According to new research by the London School of Business and Finance, which interviewed 1,000 male and female professionals of different age groups from across the UK, an overwhelming 47% want to change jobs and more than one in five are looking to career hop in the next 12 months. And over 60% of people living in poverty in the UK are in working families.

Forcing people with mental health difficulties into work says it all. Work remains the absolutely critical structure of social control in these capitalist societies of ours. Those who cannot work are to be treated as pariahs. They are the worthless lazy dependent scroungers that everyone can hate and treat with contempt – along with the homeless, the poor, the food bank users and the immigrants.

How appalling do the conditions of work have to become for us to say STOP. Something is very, very wrong. Why on earth can a parent, and especially a mother of young children, not say I don’t want to work, I want to focus on bringing up my kids?

Why is it treated as a utopian fantasy that work should be enjoyable – ‘adult play’, the psychoanalyst Donald Winnicott wanted to call it – that work be defined in all sorts of ways but basically as creative effort?

What the hell is wrong with us?

Yes, let’s have trade union power, workers’ power established at the centre of everyone’s working life. But also let’s get rid of the workerism that’s embedded in traditional left visions of a transformed society. We need so much more than the dignity of labour defining what life is about.

So let me just end on this. No, I don’t think more of the same is at all good enough. Yes, I think Corbyn’s Labour Party is beginning to take seriously the possibility of a world transformed. But there is a long way to go before mental wealth becomes the real standard by which we measure society and our political economy.

How do we get mental wealth? Labour Party Conference Fringe Event this weekend

If you’re in or near Brighton this weekend, check out this Labour Party Conference Fringe event on Sunday, led by mental health survivors and radical psy professionals, including the Mental Health Resistance Network, the Free Psychotherapy Network and the Alliance. All welcome (not just LP members).

For more than 30 years, we’ve suffered the violent exploitation and extraction of our mental wealth by successive governments pursuing neoliberal policies. So where are we now? And what do we need from a Labour Government?

How Do We Get Mental Wealth? Event details here

6 – 8pm, Sunday 24 September 2017. Ashdown Room, Holiday Inn, 137 King’s Road, Brighton BN1 2JF. Wheelchair accessible.

Call on the Royal College of Occupational Therapists to withdraw from sponsorship deal with Capita

The Royal College of Occupational Therapists’ 2017 conference, taking place on Monday and Tuesday this week, has been sponsored by Capita, one of the private companies contracted to carry out Personal Independence Payments assessments.* I have written an open letter to the Royal College outlining why I think this is a terrible idea. I am collecting signatures for it until the end of the day onFriday June 23. After that I will email it to the Royal College and also publish the list of signatories here.If you are a disabled person / service user / survivor / healthcare professional and would be willing to put your name to the letter below, please contact me with the name & title you would like to go on the letter (e.g. I will sign as Rachel Rowan Olive, PIP claimant & mental health service user).

Please get in touch to confirm even…

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Alliance update: Letters to the press on the general election

Dear colleagues,

The Alliance has taken a lead in organising two recent press letters, aimed at the election campaign, on government policies around people with disabilities and the nation’s mental health.

In the Daily Mirror:

http://www.mirror.co.uk/news/politics/must-defeat-tories-sake-mental-10494187

And last week, this appeared in the Guardian:

https://www.theguardian.com/politics/2017/may/18/vote-labour-to-uphold-the-rights-of-disabled-people

For us, an important and exciting development over the past few years has been the involvement of therapists in campaigns of a wide nature, including  disability, psycho-compulsion, workfare, benefit cuts, and mental health. Crucially, these have been campaigns in which psychotherapists, counsellors, psychologists and other professionals have for the first time joined service users and welfare campaigners to plan and participate in protest, political lobbying and street actions on issues of social and psychological politics.

The initiatives for these alliances and for a more strident intervention in the social and political field have not come from the establishment of our profession (the regulatory professional bodies like BACP, UKCP, BABCP, BPC, BPS and RCP) whose voices have been slow to rise above the careful comprises of ‘realpolitik’, but from the growing energy of radical, more grass-roots organisations like the Alliance, Psychotherapists and Counsellors for Social Responsibility, Psychologists for Social Change, the Free Psychotherapy Network and the Social Work Action Network.

If you agree with the broad sentiments in the letters, we’d be most grateful if you would circulate and share the links far and wide through all your networks, including tweeting and social networking.

You can for the moment contribute your own comments below the line of the Mirror letter – please do! Thanks very much for your support.

Our warm regards,

Paul Atkinson (for the Alliance)

The Alliance for Counselling & Psychotherapy

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