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Principled non-compliance or time for something new? A personal professional reflection following th

This conference, superbly chaired and organised by Dr Finian Fallon, Dean of Psychology at City Colleges, Dublin, was the most important psychotherapy event I have attended for a long time. Notably occurring a few days after the Minister for Health signed off legislation that will bring psychotherapists and counsellors exclusively under Department of Health governance, it was perhaps the first time that the appropriateness of state regulation had been open to public debate in this way.

Four presentations were given, followed by questions and an open forum for discussion. Barbara Brennan, Mental Health and Wellbeing Expert by Experience, spoke courageously and openly of her experience. Dr Marcus Bowman, psychodynamic psychotherapist and author, outlined the basis of his opposition to state regulation. Olive Cross, psychotherapist, presented her values as a representative of Therapists for Change. Anne Colgan, psychotherapist, spoke frankly as Chair of the Irish Council for Psychotherapy. If there was one disappointment, it was that the Irish Association of Counselling and Psychotherapy, although invited, did not send a representative to this important event.

Several themes emerged about the future of psychotherapy and counselling in Ireland, including opportunities for paid employment, the exploitation of newly qualified ‘volunteers’ and the status of psychotherapy within the HSE. These were all important, but it was the issue of state regulation which, correctly in my opinion, took centre stage.

Having campaigned against state regulation both in the UK and Ireland I must own a personal bias, but notwithstanding that bias, my sense of the general mood amongst the 80 or so delegates in the room was one of unease. In response to Marcus’ presentation, questions were raised about whether the move towards state regulation had been a serious mistake and there was a challenge to the assumption that the voluntary accrediting bodies could and would adequately represent the whole range and breadth psychotherapy and counselling in negotiations with the Minister.

Psychotherapists and counsellors are tired of not being taken seriously and of being exploited. Points well made that everyone could agree with. State regulation promised recognition of our skills and expertise. But at what cost? Do we need or want the Health Secretary in our consulting room? Can we practise at all with that infantilizing presence looking over our shoulder? Where is the evidence that such a heavy hand is, in fact, needed or that it will be in any way helpful in protecting so called ‘vulnerable’ adults?

Of the speakers, I found it easy to be impressed by Marcus because of the extremely close match between his views and my own. I was also impressed by Therapists for Change. In particular, I was very impressed by Olive’s willingness to re-evaluate - live in the room - her own views on state regulation. As the only representative of any of the voluntary accrediting bodies, I found Anne to be honest and forthright in her outlining of ICP’s position.

The therapist voices all had something important to say. But, as is the case with therapy itself, it was the voice of client experience which felt most important to me. Barbara reminded us, in no uncertain terms, that the most useful qualities in therapists are the willingness to adjust and the ability to pay attention to the therapeutic relationship. There was also no hiding from her assertions that each and every psychotherapist and counsellor has individual responsibility for the future of our professions, and that the decisions we make now effect all clients. This last point resonated with me on a deep personal level. “All clients” does not refer to the abstract notion of ‘other’; those nameless, faceless people who go for therapy. It refers to everyone, including us therapists and our loved ones. The decisions we make now will not only effect our clients, but also the clients we ourselves were, are and will be again.

The most exciting moment, for me, came on the back of a statement made by the chair in response to a question from the floor about the purpose of the conference. Finian stated that the intention of the conference had been only to discuss the issues, not create something new. And in that statement, Finian (perhaps unintentionally, perhaps through genius) introduced the possibility of the opposite; that something new might emerge from the conference. This might be the start of something vibrant and exciting.

Nobody knows what will happen next and that is part of the anxiety. But it strikes me that one thing is certain. Psychotherapists and counsellors will have to respond to state regulation one way or another. Doing nothing isn’t an option any longer. Given that the legislation has already passed, perhaps it is difficult to see any way forward other than acceptance of regulation under CORU, but two possibilities occur to me. The first is principled non-compliance. The second is to do something altogether new. As Marcus intimated, we should be guided here by our professional ancestors. We should be bold, rebellious, creative and free-thinking; just like Freud and the other founders of psychotherapy.

Apropos of nothing, I sometimes hear it said by colleagues that they are uncomfortable with the titles ‘psychotherapist’ and ‘counsellor’ for several different and unrelated reasons. Perhaps it is time to let the titles go? I think there will always be a need for 'that thing' which non-medicalised psychotherapy and counselling uniquely offers; that thing which defies definition, that magic, that intuitive non-science which can’t be adequately described in words, can’t be reduced to even the most complex psychological theories and certainly can't be evaluated by academic criteria. There will always be a need for 'that thing', even if in Ireland we can no longer legally refer to it as psychotherapy and counselling.

I don’t have a global answer to the “what next?” question. I still hope that a cross-modality alliance for psychotherapy and counselling (similar to that in the UK) might emerge, but maybe it won’t. Maybe, as a profession, we will just roll over. I don’t know.

As for my individual what next? If they will have me, I intend to join Therapists for Change. I will continue to argue for the right to practise psychotherapy legally as a non-medical and non-medicalised profession, and I will continue to contribute as fully as I can to discussions about how best to serve and protect clients of psychotherapy and counselling.

The conference was video recorded and a link should be available in a few days. I’ll update this post when I have it.

Thank you for reading.

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