Choice,the Invisible Element in Our Work

Unless they use a highly structured approach, psychotherapists make choices all the time in their work, but the role of choice is neglected in the professional literature. Because choices tend to issue under the radar, sometimes as personal enactments, our profession could benefit from examining them. This is especially true for leaders of therapy groups where there are pressures to align with conventional perspectives of pathology, of popular “goodness” and “badness.” Two important influences on our decisions here are milieu—the historical period in which we work—and our clinical identity (training, personality, identifications and practical experience). It is to reinforce these that we often make our choices.