‘That psychotherapy and counselling trainings should be based in universities’

Psychoanalytic institutes, operating as they do normally outside universities, have been criticized as being like religious institutions, with the emphasis on a narrow set of beliefs more than on critical examination of ideas, and with considerable power invested in the trainers and supervisors. Such criticism may also apply to other schools of psychotherapy. While universities have their own difficulties as institutions, including bureaucracy and even similar standardization of theories in particular disciplines, they can also represent a challenging milieu for psychotherapy and counselling education, for accountability in selection, teaching and assessment, for student participation, and for a broader critique of ideas. The difference between education and training is noted and a two-part assessment, academic and practical, is briefly considered.     

‘Critical psychotherapy,’ ‘postpsychotherapy,’ and the cult of technicism

This paper about the terms ‘critical psychotherapy’ and ‘postpsychotherapy’ argues that the terms ‘critical psychology,’ ‘critical psychiatry,’ and ‘postpsychiatry’ are already in use, and we can see the new terms – ‘critical psychotherapy’ and ‘postpsychotherapy’ – as additions to this already existing family of terms. However, this paper also argues that what is of most importance is not the case for using these new terms, but the tendencies and features these terms might be taken to refer to. The paper begins with an experience the author had while working as a counsellor some years ago. The terms listed above are explored, as are the roots of ‘critical psychotherapy’ in psychoanalysis, before providing an example of how a philosopher’s work might be relevant to psychotherapists.     

Ethics and Technology ‘in the Making’: An Essay on the Challenge of Nanoethics

After reviewing portions of the 21st Century Nanotechnology Research and Development Act that call for examination of societal and ethical issues, this essay seeks to understand how nanoethics can play a role in nanotechnology development. What can and should nanoethics aim to achieve? The focus of the essay is on the challenges of examining ethical issues with regard to a technology that is still emerging, still ‘in the making.’ The literature of science and technology studies (STS) is used to understand the nanotechnology endeavor in a way that makes room for influence by nanoethics. The analysis emphasizes: the contingency of technology and the many actors involved in its development; a conception of technology as sociotechnical systems; and, the values infused (in a variety of ways) in technology. Nanoethicists can be among the many actors who shape the meaning and materiality of an emerging technology. Nevertheless, there are dangers that nanoethicists should try to avoid. The possibility of being co-opted from working along side nanotechnology engineers and scientists is one danger that is inseparable from trying to influence. Related but somewhat different is the danger of not asking about the worthiness of the nanotechnology enterprise as a social investment in the future.     

Research and the organization of knowledge: where do psychotherapy and counselling fit in?

In order to clarify the place of research in psychotherapy and counselling, I look at the interrelationship of two ‘organizations of knowledge’. Organization can represent a process or an institution. My thesis is that there are particular characteristics of psychotherapy and counselling, considered as an intellectual discipline, that mean it organizes knowledge in peculiar ways that are reflected in the difficulty of reconciling them within the organization of the modern university. I shall propose that a different conception of research, based upon a third ‘organization of knowledge’, is necessary to resolve these tensions. Once psychotherapy/counselling finds more cohesion as a discipline, it is more likely to establish an independent niche within the university.     

Working with and ‘seeing through’ the sexual transference in the psychotherapy of an adolescent boy

This paper explores the challenges and developmental opportunities of working with the sexual transference in psychotherapy with adolescents. Psychoanalytic contributions investigating the nature of adolescent sexuality and the developmental move from a narcissistic organisation to a capacity to form intimate relationships are reviewed, and the question of what happens when there is a lack of containment in infancy is addressed. The way in which unintegrated sexual impulses and phantasies can invade the therapeutic relationship is further discussed through the account of the weekly psychotherapy of a 16-year-old boy who formed a powerful sexual transference to his female therapist. The paper highlights how working through the sexual transference enabled this young man to face his developmental paralysis and begin to use the therapy as an opportunity for psychic growth.     

Therapists’ self-reported chronic strategies of disconnection in everyday life and in counselling and psychotherapy: an exploratory study

The aim of this study was to explore how therapists believe they may relationally disconnect from other people and their clients, with an overall objective of developing methods for enhancing relational depth in counselling and psychotherapy. Participants were 168 trainee and practicing therapists, who listed their chronic strategies of disconnections (CSoDs) in everyday relationships, and then rated the presence of these CSoDs in their therapeutic work. Thirty-nine categories of self-reported everyday CSoDs emerged, organised into seven domains. Most prevalent were behavioural, passive and intrapsychic strategies. Over half of the CSoDs were rated as being present in therapy to a minimal extent, most commonly passive CSoDs, disingenuous CSoDs and humour. Male therapists, and trainee therapists, were most likely to identify their CSoDs as present in therapy.     

Digital lives in psychotherapy: ‘the other in the room’

Within the broader area of digital risk, there has been concern over the phenomena of ‘cyber suicide’, a completed or attempted suicide influenced by the internet. We propose a theoretical explanation of the ‘ambivalent self’ in people who go online searching for suicide, by introducing the concept of an inner split between the ‘suicidal part’ (SP) and ‘non-suicidal part’ (NSP) within the personality structure of the individual which struggle for domination of the inner life and external relationships and decisions of the suicidal person. This is grounded in psychoanalytic theory and draws upon a broader conceptualisation of the psyche of the self as split between rival parts, and differing states of mind, competing for control of the vulnerable individual and their capacity to tolerate and manage emotional pain and reality. The recognition and awareness of an inner split between the SP and NSP of the person who goes online, and how this influences virtual relationships, as well as external relationships, such as in psychotherapy, is an important understanding for contemporary psychotherapy and risk management in the digital age.     

Value for money?: Issues of fees in counselling and psychotherapy

Drawing on literature from different psychotherapeutic traditions, the meaning of money is reviewed, and the psychological and practical issues which arise from the setting, changing and payment of fees in counselling and psychotherapy are discussed. A person-centred approach is offered as a framework for the counsellor's understanding of fees in the therapeutic relationship.     

Overcoming Arlie Hochschild's concepts of the ‘real’ and ‘false’ self by drawing on Pierre Bourdieu's concept of habitus

This article theoretically discusses Arlie Hochschild's (1983, 1998) concept of the ‘real’ and ‘false’ self (1983: 194) and how this holds together her model about how it is we manage our emotions. Hochschild draws on ideas about surface acting, deep acting and authenticity to support her theory of emotion management. In this discussion I argue that these ideas undermine the clarity of the theoretical model Hochschild tries to develop to explain emotion management. The first aim here is to demonstrate that this concept of the real and false self acts as an unnecessary conceptual linchpin making Hochschild's ideas about emotion management opaque. The second aim in this article is to theoretically engage with Pierre Bourdieu's (1984, 1990) concept of habitus as a way of overcoming Hochschild's idea of the real and false self.     

Clients’ perceptions of personal psychotherapy or counselling for therapists

The purpose of this study was to examine clients’ opinions of therapists’ personal use of psychotherapy or counselling. Participants in this study, a nationwide sample of clients recruited through Amazon’s MTurk system, were asked to complete an online survey assessing their attitudes towards treatment use by therapists as well as their general attitudes towards psychological help-seeking and perceptions of stigma (social and self) with psychological treatments. In this study, we found that clients generally had positive views about therapists’ personal use of psychotherapy or counselling. Although overall positive attitudes were found, the results from repeated measures ANOVAs indicated that attitudes depended somewhat on whether the therapist had sought out treatment as part of a training requirement for self-enrichment, or for the treatment of a psychological problem. In addition, participating clients were less supportive of therapists disclosing a treatment use history with their clients. Regression analyses also indicated that attitudes towards treatment use by therapists were significantly predicted by general help-seeking attitudes and perceptions of stigma (social and self), but attitudes towards disclosure were not. The findings from this study have important implications regarding therapist treatment use and disclosure in practice.     

How useful is the concept of the ‘harm threshold’ in reproductive ethics and law?

In his book Reasons and Persons, Derek Parfit suggests that people are not harmed by being conceived with a disease or disability if they could not have existed without suffering that particular condition. He nevertheless contends that entities can be harmed if the suffering they experience is sufficiently severe. By implication, there is a threshold which divides harmful from non-harmful conceptions. The assumption that such a threshold exists has come to play a part in UK policy making. I argue that Parfit’s distinction between harmful and non-harmful conceptions is untenable. Drawing on Kant’s refutation of the ontological argument for God’s existence, I suggest that the act of creation cannot be identical with the act of harming—nor indeed of benefiting—however great the offspring’s suffering may be. I suggest that Parfit is right that bringing children into existence does not usually harm them, but I argue that this must be applied to all conceptions, since Parfit cannot show how the harm threshold can be operationalised. If we think certain conceptions are unethical or should be illegal, this must be on other grounds than that the child is harmed by them. I show that a Millian approach in this context fails to exemplify the empirical and epistemological advantages which are commonly associated with it, and that harm-based legislation would need to be based on broader harm considerations than those relating to the child who is conceived.     

Reinterpreting the ‘quickening’ perspective in the abortion debate

Personhood constitutes the pivotal point in the abortion debate. There exists a diversity of views as to when foetal personhood actually starts—from conception and implantation to viability and even birth. One perspective that has lost support for decades is that of quickening, a stance associated with Lord Ellenborough’s 1803 Act. This paper attempts to put quickening back into the limelight, albeit through a new interpretation. After discussing its philosophy and underpinning rationale, I will assess a number of arguments that have been directed against quickening as a viable point of distinction. I conclude by suggesting that according to modern proponents of quickening proponents, rational soul ensoulment begins after a certain degree of cerebral cortical formation has been realized, thus marking foetal volition, which promotes foetal interests, for the first time.

The ‘tyranny of time’: getting to the heart of the impact of educational cuts on the provision of guidance counselling in Ireland

The Irish Education Act (Government of Ireland 1998) stipulates that each young person in secondary school in Ireland is entitled to access ‘appropriate’ guidance. It has been argued that this very right has been eroded since Budget 2012, where resource re-allocations in guidance counselling are obstructing the requirement for schools to implement this section of the Act. This qualitative study explored the effects of ‘educational cutbacks’ from the perspective of guidance counsellors. Findings from interviews with guidance counsellors, suggest that the effects of such cutbacks in guidance counselling are far-reaching and ultimately students are the one’s losing out. The paper proposes that there is a need to reinstate guidance counselling hours to allow guidance counsellors provide a comprehensive service to young people – which they are entitled to.     

Bowlby's ‘yearning and searching’ phase of mourning as seen in adult psychotherapy

SUMMARY

This paper was given at a conference to celebrate Dr. John Bowlby's 80th birthday. The conference was organised by the External Organising Committee of the Association of Child Psychotherapists and was held at the London Zoological Society on 28th February 1987. The theme of the conference was ‘Clinical Applications of Attachment Theory’. In the paper I outline Dr. Bowlby's theory of mourning with particular reference to the processes of the second phase described by him as ‘yearning and searching’. A clinical account of once weekly psychotherapy with an adult patient is given in order to illustrate work on disordered mourning in which the patient had remained imprisoned in a suspended state of searching for her lost parent. Some resolution of this state is described together with the ensuing feelings of anger, sadness and depression as loss is comprehended.     

The factor ‘fulfillment model’ and the concept of multivariate personality type

This paper presents a theory of personality integration as a process of fulfillment within the context of a multifactor-system dynamics theory of individuality theory provides an inventory of the invariant factors in six systems: style, value, cognition, affect, sensory and motor. Individual uniqueness exists in the form of different profiles on some 200 dimensions. Similar profiles constitute a relatively small number of personality types characterized by tendencies toward both perfection and actualization. The theory hypothesizes two major types—assimilators and accommodators. Assimilators tend to process information via the individual's high profile dimensions, whereas accomodators tend to process information via both high and low profile dimensions. In general, assimilators process information more efficiently than accommdators, but they are also less flexible and more encapsulated than accomodators in their ability to adapt to the demands of a broad range of situations. The paper includes an analysis of why the concept of type is necessary for a viable theory of personality and how the multivariate concept of personality overcomes the failures of previous conceptualizations.     

Taking counselling and psychotherapy outside: Destruction or enrichment of the therapeutic frame?

This paper will explore emerging issues in the practice of counselling and psychotherapy in the outdoors, which the authors encountered when they took their clients outside of the traditional therapy room. The outdoors is defined as natural areas and spaces, such as woods and parks which have been termed ‘nearby nature’ (Kaplan &; Kaplan, 1989 Kaplan, R. Kaplan, S. (1989). The experience of nature a psychological perspective. New York: Cambridge University Press [Google Scholar]) and also more remote areas such as mountains and moors which are more isolated from civilisation, what some have termed wilderness (Mcfarlane, 2007). Particular emphasis will be given to the ‘frame’ of psychotherapy and how aspects of this are affected by moving outdoors, in particular contracting in relation to confidentiality and timing. The relationship in psychotherapy will be explored in relation to issues of mutuality and asymmetry alongside the role of nature in the therapeutic process. Lastly the challenges and therapeutic potential of psychotherapy in nature will be explored.