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