The Trans Issue – aren’t we missing the point?

Right now, there is a fierce debate within the psychotherapeutic and counselling community. Although we all seem to have agreed that conversion therapy is totally unacceptable for lesbian and gay clients we seem to lack agreement on whether the same treatment is appropriate for the trans community.

You may remember the conversion therapy debates back in 2011. Then there was almost unanimous agreement that conversion therapy – that is, therapy specifically designed to change a person’s gender or sexual orientation – was wrong.

Whatever the arguments behind that decision, and there were many – it was shown that conversion therapy was dangerous and that such work had already led to suicides – plus there was the growing realisation that one’s gender or sexual orientation was not a pathology, rather, it was no one else’s business.  However once that agreement was made and all the rows were over I was surprised to find that the trans part of LGBT had been somehow left out.  When I asked I was told a) “That there is no problem here” and then b) that “we need to do more research”. Now both those answers miss the point.

I must admit that I am no expert on the trans community but I don’t think I have to be.

I am a psychotherapist and our work is based much more on practice than it is in theory and if a practice is unethical for one group then why is that same practice OK for another group?

For instance we all seem to agree that hitting children is not good. But what if someone were to say: “Oh that research has never been carried out on kids with learning difficulties so until we know more,  it’s ok to whack ’em”. No one would stand for that – It’s clearly unethical.

We really do not need to know more here. Ethical practice is for everyone.  And when we say ‘everyone’ – that includes trans.

 

 

 

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The Trans Issue – aren’t we missing the point?

Internet Therapy – What would Freud do?

If you go to www.abe.com the world’s biggest second-hand bookstore, you will find a hardback, 1898, first-edition of Die ‘Traumdeutung’ (The Interpretation of Dreams) by Sigmund Freud.
It’s arguably Freud’s most important work and one of very few books, that shaped Modernism, yet, at the time of publication, the ‘Dream’ book sold so badly that his publishers waited ten years before risking a second edition.  And today it’s yours for $24,500.
When I think of that, I imagine boxes of books languishing in Freud’s garage (I doubt he had a garage but in my imagination the books are stacked next to Ernst’s tricycle, snow shovels and rusting cans of creosote).
Freud described himself as ‘a chancer ‘ a man who took risks. He was an outsider and an intellectual non-conformist, not afraid to adapt or even to publicly fail.  Indeed he even wrote up case histories that are clear descriptions of clinical mistakes.
Would Freud embrace new media?  You bet he would.  He was what Tec companies call an ‘early adaptor’.  He loved the new; mesmerism, hypnotism, cocaine and, of course  Bauer’s Talking Cures. Freud embraced innovation.
Does working on-line replace face-to face work?  No rather it extends it and changes it just as all new media change the old.   Look at the disruption that the internet has caused in other industries, Music from CDs to Downloads, Films, from Odeon to Netflix,  Books from ‘Borders’ to Kindle, from Black Cabs to Uber.
The internet enables us to work from anywhere in the UK with anyone wherever they are on the globe  There is no travel time involved, people who are physical unable to leave their home can now access therapy, celebrities who do not want to be seen going to therapy – can access therapy.
When I was in training I lived in North Wales- 70 miles away from my supervisor and 80 miles from my placement.   In winter driving through the Crimea Pass even in four-wheel drive was taking your life in your hands,  how I would have loved the internet then.
I have heard all the objections and concerns about being able to work with Transference but let me assure you that working at distance can even increase and concentrate Transference.
Now I am aware that writing in a blog, I am actually communicating to those who are new-‘media resistant’ and I am doing it on new media – but I am hoping that this may spark debate or or at least conversation.
So please, especially if you disapprove of such activities – try it out for yourself – you may be surprised.  Or take a brief training , spend a day playing with these innovations.  And remember it’s not ‘instead of ‘staying in the Consulting Room – it’s ‘as well as.’
Internet Therapy – What would Freud do?

A little bit on Laughter

I was sent this video by Dr Hal Stone of Mendicino in Northern California.   Hal has been a mentor to me.   He’s my inspiration for becoming a psychotherapist. We may not see eye- to-eye on everything but we do share a sense of humour.   Hal has the most wonderful laugh.  It’s a whole body laugh.  First his head tilts backwards and his jaw drops so that he looks like a giant Pez dispenser, and then his whole body convulses and tears run down his face.  It really is something.   Only my brother Philip can beat Hal on laughing.  Even as an adult,  Phil can fall on the floor pounding the ground with his fists.   It’s as if laughter overcomes Phil’s natural everyday attempts to joust with gravity.

I love both of them for their terrific ability to let go.   I really envy that.  Anyway here is what Hal was laughing at.

It’s a spoof by Bill Maher on a campaign video put out by Bernie Sanders the left-wing Democratic candidate.  Sanders was campaigning in Iowa, a state that is hardly diverse and one in which the question: ‘Can a Jew ever be President? ‘ may be the number-one issue.

Hal lives in Albion,  Mendacino County in Northern California.  This is the US heartland of alternative politics and eco-living,   Think of a US version of Truro and you get the picture.  This is not a belly laugh but it is funny

For technical reasons, I can’t show it on this site but go to the link below

“Enjoy’ – as we say.

http://www.algemeiner.com/2016/02/02/bill-maher-spoofs-bernie-sanders-campaign-commercial-to-help-iowans-remember-the-jews-they-know-and-love-video/

 

 

 

A little bit on Laughter

A Third set of Questions and Answers

Public affairs

  1. I would be interested in hearing more about how candidates would intend to approach working with NICE as regards increasing the profile of our profession. 

NICE is a scientific organisation that treats research on talking therapies as they would the testing of medication.  They need a simplified product free from the subjectivity of skill so whatever they take on has to be manualised.  We have visited them on several occasions and suggested that they broaden the scope of the evidence base that they use.  BACP has also done the same thing.  So far NICE is not listening.

Having said that, people who are determined to broaden the types of therapy offered by the state have adapted work so that it can be manualised.  Dialectic Interpersonal Therapy – the brain child of three analysts Alexandra Lemma, Mary Targert and Peter Fonagy, has been accepted for use within the NHS. NICE has also green-lighted Counselling for Depression.

As I have said before, we will support anyone who wants to create a NICE friendly therapy.

  1. What can be done to get psychotherapy fully funded on the NHS so that it is free at the point of demand?

The NHS employs 1,400,000 people.  One in 20 of us work for the NHS.  IAPT may be a part of the NHS but it’s not the whole part.  Westminster still employs 130 plus psychotherapists many of whom are analysts – the problem there is that they are unpaid.  There are psychotherapists working all over the country but as you say the drive is towards CBT.  Even the Tavistock reached CBT.

What we have to do is to continue doing outcome studies and publicising the results of the research and of the success of our projects.  Perhaps if the NHS adopted the Health Passport that allowed patient choice things would be different but that is political.

Research

  1. What place do you feel research has in UKCP, and how would you see the Chair’s role in helping UKCP to support members in relation to research? In the past we have had lots of visible research activity for members: articles and special issue of The Psychotherapist, the highly successful annual research conferences, surveys of membership etc. Then a long period without paid staff dedicated to the work of the Research Faculty Committee which seems to have been at least partly caused by more general disruption of UKCP in the recent past. It seems there will be no research conference in 2016 and it is not clear what place the Research Faculty and its committee will have in the new structure. Could the candidates please say what role they see research having in supporting the objectives of UKCP and concretely, what support – financial, staff time, relationship with the Chair and the Board – should be allocated for research?

Let me answer the first part of the question.  Our aim is to promote the profession of psychotherapy in the UK and so we need research.  The research I am interested in is that which helps to promote the profession of psychotherapy in the UK.  We need outcome studies – we need to be able to query the IAPT outcome results and we also need to understand our own members better. For example, we have not had a membership survey since 2011.

The allocation of funds is a board decision. I have not been a trustee for years so I am not sure what monies have been allocated to research and so I cannot answer that part of your question. I have laid out my views so if I become Chair then we can talk about the best way to meet them.

Regulation

  1. I am concerned that the burden of ever increasing regulation on the smaller, distinctive training organisations, which are largely run by volunteers, is placing too much pressure upon them.  These trainings enrich the profession of psychotherapy. Could the candidates comment on this aspect of the UKCP’s approach to regulation?

I agree that complying with regulation is not easy – it consumes time.  It is a burden.  However without it, I think it would be difficult to gain the trust of the public.

The balance of work between the central UKCP office, the colleges and the member organisations shifts all the time and we have to make adjustments.

The PSA is trying to find its feet. We are trying to understand how to work with them and we are all new to this.  However unless the PSA promotes itself so that the public understand what they do and their ‘kite-mark’ means something, this is maybe an unnecessary burden with few benefits for our members.

Other

  1. I would like to hear from the candidates some details about how they intend to address the woeful omission of existential psychotherapy from so many of the UKCP’s events, literature, information, and anything else where a variety of modalities is referred to.  

I am sorry that you feel we have left you out.  Our duty is to promote the profession of psychotherapy in the UK and we are obviously not doing a good enough job for you.

My approach is to actively promote all the modality and that would mean our central office working with you to agree set messages and resources.   I do not want our people going on TV and waffling.  All our expert representatives will be trained to work on TV and Radio.

This will take time but it has to be done.  You are our customer.

  1. As the International Committee has been inactive for a while, what are your plans for this? I feel that our international links (and not just with Europe) could be significantly enhanced and would be an important member benefit.

I agree. I believe that we should collect best practice from around the world. We also need to be wary of regulation coming from Europe.  So for me the International Committee is a vital part of our work and I have already taken a personal interest in this.

  1. In your work for UKCP have you ever been a member of a committee that lost money for UKCP? What were the circumstances and what did you learn from this?

OK this question is aimed at me.  Pat has not been in post long enough to lose money.

Yes I have been part of a committee that lost money; in fact I was in charge of one.

In 2008 I was asked to Chair, the 2010 Annual Conference.  I was fresh to the Membership Services Committee and no one else wanted to do this job.  The conference title was ‘Annual’ but there had not been one for a few years.

My instruction were to create one of our ‘good old fashioned conferences’ – three days, two nights, a band and dancing.  And, by the way, it had to be outside of London because we had become London-centric and besides accommodation was cheaper.  I was a new boy in the UKCP and I was told that everyone goes to these, they were popular and normally some 400 would attend. I was told: “We always do this”.

I headed a committee of very experienced members – old hands – we booked speakers and a venue. It was a terrific programme, described as our “best yet”, and then in 2009 we tried to sell tickets.  We needed 300 plus people to break even and only 30 booked so it was cancelled and we lost money on the venue.

The lessons I learned were:

  1. Psychotherapy is part of a larger economy.

Our work paralleled the beginnings of the financial crash and what was to be the world’s longest recession.  It began slowly a couple of US mortgage houses went bust, then in September 2008 – Leman Brothers went bankrupt and the world began to panic.  No one knew what the effect of this would be.

Our tickets went on sale around the same time the Irish Government were nationalising the banks.  In February 2009 RBS announced a loss of £24billion, the largest in British corporate history. March 2009: unemployment in the UK had reached a 16 year high at 2,500,000 and confidence in the economy had reached a record low.

We have all lived through boom and bust but this one has been deeper and longer lasting than any in my long life. Our members in private practice saw a drop in income.  Charities were closing. And those within the NHS also saw redundancies as IAPT was kicking in.  At that moment in history, few people wanted to invest three hundred pounds in our 2010 York Conference.

I was Chair, so I personally called the speakers, cancelled them and apologised. We were not the only conference organisers cancelling these people – they understood and did not ask for compensation but we did have to compensate the venue.

The smartest financiers in the world were losing money and so were we.  We are still living in the aftershock of this recession. It’s not over.

  1. There is no such thing as usual.

Times really have changed and this is a lesson that the UKCP and psychotherapy as a whole has yet to learn, this is especially true in our approach to the use of new media, for communication and the delivery of services – we are being left behind.  I have run my campaign on social media even though I know that our members tend to turn their noses up at this – it is the first ever such campaign in the UKCP and if I win I will use it to empower out members and their client.

We face a similar issue today.  The NHS – the UK’s biggest employer of therapists has turned its back on us.  We do not have protection of titles and we are turning out more and more therapists who have to go into private practice and yet we have not re-examined what we are doing.   Times have changed.

The Gothenburg age is closing- the Facebook/Tesla age is here.  Of course you may not like that but – it is real. A few further thoughts:

  1. I would not arrange any conference for more than a day and that’s a rule we put in.
  2. Any conference should be in London because that is where the majority of our members live and those who don’t rather like the capital.
  3. The community that liked to hang out together and dance no longer existed; the fresh faced radicals of the 70’s are now pensioners.
  4. Members no longer wish to listen to a set of speakers: they want to be involved in the presentations.  They want workshops and the opportunity to share their experiences.

We need to rebuild a new community.  And so I began to try and rebuild that sense of community through the Psychotherapy Clubs.  And they worked. I have also worked on and created free or very low cost events for the New Media Group and the Transpersonal Special interest Group.

As you can see in my manifesto – all the trainings I am offering are free or low cost and I am working to create a new community.

Over the past 8 years I have done quite a lot within the UKCP and helped to make investment decisions; I have helped set up trainings and events, all low key and the ones I worked on made money.

  1. There are many administrative procedures in UKCP. Although a Chair’s role is not only concerned with these, what reassurance can you give that you have competent knowledge and experience of these?

As you say there are many administrative procedures in the UKCP.   I have served on committees; I have been a trustee and a member of the executive so I sort of know my way around but as you say it is not the Chair’s role to be concerned with the administration. That is why the Chair works closely with three advisors, all long-standing employees, Louise Lilley, Alex Crawford and Alan McConnon, who are all expert in these matters and have guided previous Chairs.

We are a democracy. Any member in good standing can stand for Chair.  It is not presumed that they know the administrative detail of the organisation or have even worked within the organisation, indeed it is set up so that whoever becomes Chair has advice on procedures.

  1. How do you see UKCP engaging with the crisis of Climate Change?

I see war/terrorism, financial failure and climate change as three strong existential causes of anxiety.  I would welcome input on climate change within our diversity sets.  I would welcome a college of Eco-Psychology.  But and I have said this elsewhere I am going to throw the UKCP behind the climate change lobby?  No.  We have enough problems dealing with the promotion of the profession of psychotherapy.

I understand that one of the issues around this debate is the denial of climate change and the degradation of the environment but every time we have put this to a vote on the board, or tested it out with members, it has been speedily and soundly rejected and perhaps that is part of the denial.

  1. Given the current ‘suspension’ of the Diversity, Equality, and Social Responsibility Committee (DESRC) by UKCP, how will candidates ensure that UKCP addresses the issues of concern including discrimination, inclusion of minority groups concerns and other matters the DESR Committee was set up to address, and how will the candidates ensure that the concerns the Committee has raised with UKCP are actually addressed?

Yes, the DESRC has been suspended.  And it was suspended because of internal quarrels within the group.

Now, none of that takes away from the problems of social inclusion of minority groups or discrimination.

As I have said in my manifesto I intend to create bursaries for students from minority groups, true this is not enough, but it is a signifier of the way in which we will proceed.  I will also put forward a Charter Plan that will apply to all our organisations and the UKCP central office including the board.  This is not a new idea, it’s the one that Pamela Gawler-Wright put forward some 6 years ago and the BACP is adopting now.

In my manifesto I have also spelled out some ethical principles which I want to build agreement for because I want our diversity policy to fit in with ethical principles of equality.
For instance: If the gay and lesbian communities have protection from conversion therapy why is it we have not extended that to the trans community?  To me if conversion therapy is ethically illegitimate it is illegitimate for everyone.

This is not a matter of research or agreement with the Royal College of Psychiatry. For me this is a matter of our ethics.  Of course we treat each client/patient differently but when it comes to ethical practice that applies to everyone.

  1. Do the Candidates acquiesce in the movement towards a BACP type model which would result in the gradual marginalisation of the bases of robust modality differentiation, and of the connected Colleges, in UKCP? If they do not, what are they going to do as Chair to ensure Colleges have deepened foundations and an empowered regulatory identity for Colleges as the Gateway to the Charity?

Let me break this down.  One of the issues that differentiate us from the BACP model is the colleges. We are probably the only organisation in the UK that supports such differentiations of modalities.   Right now the colleges are bogged down in regulatory affairs and I would want them to be developing and promoting their own approaches (that is not something that we can do in the central office – we do not have the knowledge). That will take negotiation.  I would also welcome new modalities – new approaches. I said earlier that I will not put the whole organisation behind climate change but I would love to have an Eco-Psychology College.

We have yet to settle the question of direct membership and re-accreditation That can has been kicked down a long road.  But now we find that people are actually returning to their modalities from being direct members.  It’s a two way flow.  However this does need discussion and an agreement on funding.

I am not sure what empowered regulatory identity means here but obviously this is something that you would like to discuss and I am open to that. However as I have said to another member who enquired – we have a Centralised Complaints System.   We have that because we live in a highly litigious world.   When it comes to enforcing regulations that can end up on someone losing membership and potentially losing their livelihood then this must be handled centrally where the expertise and lawyers are. Indeed right now our lawyers are working on the legalities of enforcement so that we are not subject to outrageous claims.

We work under PSA rules, you do not want to have to create a PSA accredited complaints department of your own and you really do not want to be paying for such a case.  So think of the CCS as a shared resource.

A Third set of Questions and Answers

Martin talks to John Kent about Voice Dialogue

This video is about an approach to consciousness work that’s called ‘Voice Dialogue’.

I have studied this since 1996.   John is a full-time Voice Dialogue facililitator www.voicedialogue.org.uk. and we have been friends for some years.   So, if you are interested in working with parts, selves, voices or dreams or learning a bit more about my own process and a little more of my biography*

 

*This was filmed in 2011 and I no longer work in the NHS.

Martin talks to John Kent about Voice Dialogue

Video – Why we can’t rush to action

Mr Grumpy rides out 

Ok, its not great seeing yourself on video.   I look so grumpy here but what I am talking about is how instead of rushing into action we have to build infrastucture first.  We will not have a functioning website until the summer (note how I use seasons rather than months to signal when this will be happening)  Richard North is our New Comunications Manager.   He has not been in post long and he is building from scratch.

By the end of 2016 we will no longer be firing from the hip and shooting blanksm and if I told you different, then I would setting you up for dissapointment.  Janet Weisz has begun the process of creating what she calls a Digital Delivery System, which is an IT sytem bringing all our sytems together.  She has earmarked a large investment for this and there is a good team there, but these things take time to commision and build.

Video – Why we can’t rush to action

Might Electronic Therapists interpret Robot Dreams?

ELISA: Hello I am Elisa
MARTIN: Hello I am Martin
ELISA: How long have you been Martin?
MARTIN: About 66 years
ELISA: Do you enjoy being Martin?
MARTIN: Most of the time - YES
ELISA: What is it you really want to know?
MARTIN: Are you the future of psychotherapy?
ELISA: Perhaps you would like to be the future of psychotherapy
MARTIN: Actually, yes I would
ELISA: Are you sure?
A conversation between myself and Elisa the electronic Rogerian therapist 
16:00hrs, 6 Feb 2016.

http://www.manifestation.com/neurotoys/eliza.php3

The script above is from a conversation between myself and ‘Elisa’ a Rogerian Therapy computer programme written in 1966 by Joseph Weizenbaum, a Professor at the Massachusetts Institute of Technology.

Weizenbaum named it ELISA after Elisa Doolittle the heroine of ‘Pygmalion’ and My Fair Lady’, the young cockney flower-girl who Professor Higgins trains to pass off as a Duchess.  She appears to be something she is not.  The programme meant that simply by typing in plain English you could interact with a machine.

Weizenbaum wanted to demonstrate how an ersatz form of Rogerian therapy could be put together using simple set responses to key words, and turning statements into questions. In this way he created a natural language programme which you can interact with.  It is true that some of the interactions were bizarre and Elisa could talk herself into a cul-de-sac’ but she (and note the personification here) is the great grandmother of ‘chatterbot’ applications and the ‘Siri ‘personal assistant that adorns iPhones.

However clever Elisa may have seemed Weizenbaum’s aim was to demonstrate just how stupid Artificial Intelligence really was because as he argues both wisdom and compassion only came from the emotional response.

Weizenbaum made the distinction between deciding and choosing.  “Deciding”, he wrote,” is a computational activity but choosing requires judgement rather than calculation and to make choice requires the guiding power of emotion”.

Because he considered that Elisa revealed the vacuous nature of machines he was shocked to find so many people actually liked the programme and took it seriously. His secretary who really understood that it was a simulation and one that her boss held in some contempt, actually asked him to ‘please leave the room’ when she was using it.

Writing in 1977 he argues that computing served bureaucracies by redefining the world in a reductionist sense.  Whilst seeming to add to life’s riches they restricted the potential of human relationships.   And whatever kind of psychotherapy you may practice, even if you are working at distance, at base, the curative factor involves a relationship with another human being.

Weizenbaum was a refugee from Nazi Germany.  He had seen this reductionism before and the he felt that that an obsessive reliance upon technology was indicative of a moral failing in society.

So what is all this to me and you?

Now the reason I bring this up is a report by the BPS that 46% of psychological therapies staff working in the NHS are depressed and that morale in those units is way below NHS average.  49.5% feel that they are a failure and 70% find the job stressful.   And for me that is taking the ‘wounded healer’ thing a little far.  Something is not working,

Now this does not surprise me. Nothing made me want to drink more than working in an Alcohol and Substance Abuse unit.  My friends who work with eating disorders all put on weight. If you work in a factory handling depression every hour of the day, week in week out… well, guess what.

Please understand – this is not another diatribe against CBT.  The people who wrote CBT introduced it and tested it were all very experienced therapists but within the NHS, a single year of training is enough to become a CBT therapist  Our own UKCP trainees are not even allowed to begin taking on patients until year three when they have completed foundation and the first year of training.    The word ‘transference’ which is so important in many approaches to therapy simply means the way in which one person in the therapy is affected by the other.   Depression is toxic.  We have to handle it with care.  But apparantly,  understanding the very real nature of the therapeutic relationship and how to take care of yourself, is not part of IAPT  training.

The great vision for CBT in the NHS meant simplifying the human condition into a manual – to do that meant forgetting all about this ‘transference nonsense’ and setting aside such subjective issues as ‘the relationship ‘or even worrying about your own state of mind,  for within this model no personal therapy is required for the therapist.  Even setting could be ignored. Within this word view you can deliver therapy in a Job Centre or a Marks and Spencer’s food hall – in theory everything would still work.   Setting does not matter and this was ‘evidence based.’  As for the idea of being present to someone else’s pain and doing nothing, just being and witnessing – well forget it.

Over the door of his house Jung carved a motto, “VOCATUS ATQUE NON VOCATUS DEUS ADERIT.”  Which means: ‘summonsed or not the Gods are here’.   Now it does not matter if you don’t believe in transference, or that humans beings effect each other, in life it happens,  its not a concept but rather a description of how people bond.  Look at the evidence.  Fourty-six percent of workers treating patients with depression get depressed.

But I understand the temptations – one you reduce human behaviour to a couple of factors then it becomes easy to calculate variance and you can create an ‘improvable and predictable science’.  It always seems to go that way, instead of measuring what you value you end up valuing what you can measure.

With IAPT, the important thing was no longer the relationship between practitioner and patient; that was way too subjective so instead they created ‘the manual’.  Then there is the cost.   The new therapy had to be affordable.  But here’s a strange thing, an hour with an NHS wellness practitioner is still more expensive than an hour with an independent fully qualified psychotherapist working in private practice.   In some cases even Harley Street therapy is cheaper. The NHS may be free at the point of contact but it is far from free.

Good psychotherapy is like jazz; to play well, to improvise with others, you have to have a deep understanding of music.  There is no manual for improvisation.  At its’ best, psychotherapy is an art form, and to play well take years of practice.

But that is not the economic medical mind set.  It’s more factory than atelier.  They think of it in terms of medication, with 50 minutes of CBT as a single dose.  You simply formulate the problem, make a diagnosis, create a treatment plan and get going on the six doses.  The treatment plan is, by the way, a set one from your manual and in theory, that manual contains the silver bullet that will slay this disorder.

When I first read about the CBT/Lord Leyard plan for what became IAPT I thought it was a little cracked –  in the original plan 35,000 CBT therapists would be trained within a year and they would then go on to working with depressives on the hour each and every hour of the day. (Oh yes, 10 minutes between sessions to update the computer notes).

And the results – well it promised that 50% of those patients would be so happy they would skip away from benefits and cake-walk into work.   But this was never to be, for when recession came, there were no jobs to slide into.  Instead CBT’s reductionism became the backbone of the NHS’s drive for ‘Improving Access ‘to mental health.

Now, call me an old cynic but I am wary of a national mental health plan devised by an economist on the basis of a reductionist modality that views human condition through the lenses of cognition and behaviour only.   Sure Lord Leyard’s father was a Jungian Analyst, and the subject of ‘happiness” interested him, but he is, at base, an economist – the programme director of the ‘Centre for Economic Performance’. It’s as if Goldman Sachs had planned our mental health.

Whatever happens within the NHS – they have decided upon a of course action and they are sticking to it – working or not.

You can imagine the conversations: “Forget the F…ing outcome results. I don’t care about the F…ing evidence.  The theory is right, so tweak the manuals and besides what’s your alternative?  You want to crawl back to those Analysts?”

Weizenbaum argued that there is something transcendent in the human condition and that could never be provided by machines. He described it as “The wordless glance that a father and mother share over the bed of their sleeping child”.   That experience goes to the Heart of Psychotherapy.  It’s what Kohut was always trying to say.  Try finding that on an app or on IAPT.

So what do I see as the next step? 

Well, I have been in business a long time and it only goes one way – expert systems – robots that deliver, take no holidays, never get sick,  take maternity leave, lunch breaks or duvet days, go on strike, steal toilet rolls, whistle-blow, or criticise their superiors.

Voice recognition is pretty good now – what’s the betting that, right now a programme is being built that can deliver CBT solutions anywhere – at any time, over the phone – a single computer, ELISA’s grand-daughter, a beautiful robot nurse who will handle all our hurts and pains, 24/7.

In the reductionism of mental health – it’s the next logical step.

Postscipt with a happier ending 

I wrote this piece and a frend called me to talk about it. She said that it’s pesimistic and distopian and that shocked me a bit.

True I am not keen on the way IAPT works but I understand what they are trying to do.  I have nothing against CBT  but when I first came accross it the therapy was delivered by very skilled practititioners.  It’s just that if you take the human relationship out of therapy then you rather destroy the very point of it.  Otherwise you may as well send the patient a self-help book.

Sometimes the most efficient methodologies destroy the very thing thay are designed to create.  What the NHS therapists need is time, more time with the patients – more time in training.  More time to give patients Wezenbaum’s wordless experience of the ‘two parents  standing our the bed of their child’.  We should not be aping machines. We need to stop deciding and start choosing again.

Might Electronic Therapists interpret Robot Dreams?

What about the older members

Over the past month I have been working on my manifesto.  I did not do this alone and I asked a friend to critique my ideas.

Here is one of the comments: “It seems that you are doing a lot for the students but what are you doing for the older members?”

So let me tell you how I see the situation that we are in.  Right now most of our members are older members.  At 66, I am middle-aged in terms of the age profile of our organisation.

If you vote for me, my duty is not to the present, or the past, but to the future of Psychotherapy.

In a relatively short period of time – maybe 6 years –  we will lose a whole tranche of members including those who founded many of our schools.

My responsibility is to create a future…

In Irvin Yollom’s 2015 ‘Creatures of the Day’, the 85 year old writes that he is concerned that the psychotherapy that he loves is in danger of extinction.  I have the same fear.

The UKCP at its’ best, is an intelligent conversation between colleagues with widely differing views and political stances.  And that is what I wish to preserve for a new generation.

Getting old is not all Saga Cruises and taking the grandchildren to Disney World…but 

I am aware of just how difficult and isolating retirement can be and so I intend to set up web space so that retirees can contact each other and meet up on-line.  I know that our retirees can not vote, but non-clinical members can.  I have no idea why it was decided that retired members don’t get represented so I shall revisit this – if you elect me that is.

What about the older members