This video is about promoting the profession of Psychotherpy in the UK.
This video is about promoting the profession of Psychotherpy in the UK.
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.
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.
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.
Since starting my campaign for Chair I have spoken to hundreds of our members both in large meetings and on a one-to-one level.
And I am horrified to find out just how the UKCP has lost contact with our members – and remember I have been a trustee, a member of the executive and I have sat on several committees. Many of our members are disaffected.
I may paint myself as the outsider contender because I am no longer on the board, but for 8 years here I have lived at the heart of this organisation, so I hold up my hands: no blame and no excuses.
A membership survey that was undertaken 2 years ago showed that 28% of our people were dissatisfied with the UKCP.
That left 72% of respondents thinking everything was rosy. But they were the people who were not actually involved. You see there are plenty of members who want their UKCP registration certificate renewed every year – and that’s it – and that is OK. However the 28% who weren’t happy expected more.
Then there is a small percentage of the membership who has actively tried to engage with the UKCP and have been ignored or worse insulted. Some are really hurt.
The UKCP will never be some Shangri-La, or Happy House…. we are there to perform a function, and it is true that some of our members can be ‘difficult.’ However even the difficult ones are ‘family’.
My aim is to have an organisation that people fight to join. But right now that would be unrealistic – let’s start by making it a ‘good enough’ membership organisation. And that is my ambition for my first six months in office.
I want to meet those of you who are disappointed and hurt and see if we cannot do some practical healing. I want you back.
And to do that I have to be elected.
Feel free to contact me below either directly or via my social media accounts:
There’s this wonderful story. John Bickerstaff, ‘the man who built Blackpool ‘ was a visionary and the Town Mayor.
In the late 1880’s he visited Paris and saw the Eiffel Tower. Bickerstaff immediately decided that this was exactly what Blackpool needed. You have to love him.
So, in 1891 he set up the Blackpool tower committee. From local mill-owners he raised the equivalent of some £60,000,000 and work began. His real pride however was not the Tower so much as the Ball-Room. He wanted to give his mill-worker holiday-makers, operatic levels of gilded luxury. Anyway… he is talking about his Ballroom with a friend, who chides him. “You are spending £100,000 on a carpet and those peasants will come in and spit on it.”
Bickerstaff ignores this, but the next morning a huge sign was erected outside the Ball room. It read:
“Come on in and spit on John Bickerstaff’s £100,000 carpet”
Now I am telling you this because if I am elected then I shall invite you to complain. We need to lance the bad blood between us. So if I am elected I am inviting you to come and spit on my carpet. I want to know your gripes. I want to bring the membership together because that is the only way in which we can achieve our aims. And if I am not elected, then please go spit on Pat’s carpet
Candidate for Chair of the UKCP 2016
I am 66 years old, married, live in London and I am standing for election as Chair of the UKCP.
I have considerable professional expertise and experience which I now wish to put to good use as Chair of our professional body.
Psychotherapist and Supervisor in Private Practice
(2008 – Present)
For further information, please see my website: www.psychotherapyW2.co.uk
Previous psychotherapy work experience
I served placements in CAIS (a Welsh Alcohol and Substance Abuse Clinic) and three years in MIND; a year in Wrexham and 2 years in Harrow Road West London. From 2006 -2013 I served one day a week in the NHS, Community Mental Health Team Soho where I was an Honorary Psychotherapist.
UKCP and Professional Association Experience
2015-16 Member, UKCP Executive Team.
2013-16 External Moderator of The British Psychodrama Association.
2013-2014 Chair of the Association of Humanistic Psychotherapists.
2012-16 Committee Member of the Transpersonal Special Interest Group.
2012-16 Member of the Book Editorial Board.
2012- 2015 Trustee UKCP elected representing Individual Members.
2010-13 Member of the Membership Services Committee.
2010 Awarded ‘Certificate of Recognition by the Board of Trustees of the UKCP’ for an ‘Outstanding contribution to the UKCP and services to Psychotherapy’.
2010 Chair of Annual Conference Committee.
2008 Created www.thelongboathome.co.uk, a network of UK therapists who offered to work for reduced fees for ex-servicemen and women and their families.
2006 – 2012 Trustee and then Chair of The Minster Centre.
2008-10 Member of the Political Group UKCP, working with the then Chair James Gray Antrican to create external strategy.
2008 Joined UKCP and addressed the AGM to gain support for the Long Boat Home.
2014 Completed Metanoia’s Supervision Certificate Course.
2008 Awarded MSc in Integrative Psychotherapy from Middlesex University (The Metanoia Institute) communications strategy.
1998 Awarded MSc, Change Agents Skills and Strategies from Surrey University – this was their Humanistic Course founded by John Heron.
Previous Management Experience
1996 I married and moved to a hill farm in North West Wales. After so many years in business I needed to get earthed again.
1996-2009 Management Consultant. Self-employed working through two consultancy specialists, The Merchants Group and Acadamee, helping companies (e.g. British Midlands Airways, Shell Home Fuels, Porsche GB).
1994 -1996 The Merchants Group, Head of Communications and Marketing and member of the small team tasked with selling the company- specialising in Call Centre management. Sold the company to Dimension Data of South Africa.
1981-1996 Co-founder of the Programmes Group (later renamed The Merchants Group). Head of Communications and Marketing (also briefly managing finances and credit control). Group started in late 1980 as an ‘Exegesis’ sponsored job creation scheme named, ‘The Bristol Project’. The idea was to show that, in a recession, at a time when youth unemployment was high, by working together in co-operation young people could create their own jobs.
We created several companies but the most successful was Programmes Limited, a pioneering telephone marketing agency. In 1981 there were probably around 200 people in the Telemarking trade in the UK. Within 10 years we had trained 400,000 people in Call Centre skills and 2% of the UK working population of the UK then worked in Call Centre type environments. The job-creation scheme worked.
As Head of Communications and Marketing I also became a Key Note conference Speaker teaching across Europe, Australia and the States.
King Edwards High School, Birmingham
HOW TO CONTACT ME:
The UKCP’s founding aim was to promote the profession of psychotherapy in the UK and this will be my priority if you elect me as Chair.
Let’s face it: we now have a regulation system backed by the Professional Standards Association and we have a strong centralised complaints system; that’s all good – but professionally members are suffering.
At a time when more and more money is going into mental health, opportunities for our members have not grown; they’ve shrunk. That’s going to change.
What you can expect from our Membership Organisation
From the moment anyone considers a career in psychotherapy, the UKCP will be there to help them choose a course with one of our training organisations.
Students enrolled on our courses will get free membership (more of that later). The UKCP will be there to help them find a placement, when they qualify help them find a job, find consulting rooms, put together a group or community practice and attract new clients.
At low cost – the UKCP will offer members training on how to create and build a website, work online, increase their earnings and also create opportunities for members to publish, promote, blog or broadcast. If you have a professional issue, the UKCP will be there to help you.
The UKCP do not see clients. We do not teach psychotherapy. Our members do that and by backing our members we are backing psychotherapy.
If unpaid jobs are the only ones on offer then, is that really volunteering?
This is a big issue, it upsets me. Many people regard psychotherapy as a vocation, but so is being a Doctor, a Nurse or Teacher – and they get paid.
If the government chooses to outsource mental health services to charities whose business plan is based on long-term unpaid volunteers – should we support that?
If we want diversity, then we need to put an end to the assumption that psychotherapists are wealthy people who work for free.
If we wish our time to be valued, we must first value our time.
Without well-paid jobs in the NHS, private and charitable sectors, we cannot further build the profession, and diversity becomes simply a pipe-dream. And so, we are going to target paid job-opportunities for our members and help our profession negotiate their relationship with NICE, so that we can return to work within in the NHS.
Diversity is a practical issue and we need practical solutions
In year one, we will set aside a small bursaries fund of £25,000 for those students and members who need a helping hand. £20,000 will go to students who are members of socially disadvantaged groups and £5,000 will be there to provide small grants or loans to members who fall on hard times. True, it’s a small start but it’s a start, because a real profession looks after its own members. (More about Diversity on my website https://martinforchair.wordpress.com)
Ordinary, Everyday Diversity
We are a progressive organisation. All people should be included in the same rights and protections ensured by our commitment to excellence and ethics in action.
At an equality level, that means upholding common ethical standards for everyone: honesty, competence and non-discrimination.
That means we train ourselves to recognise and responsively serve the infinite variety of needs of individuals and communities who are usually marginalised.
How does all this fit with the regulatory and charitable aim of protecting the public?
The UKCP is there to ensure that more people can gain access to safe and regulated psychotherapy. The safer people feel about psychotherapy, the easier it is to grow the profession.
Separating the Regulation and Membership functions
The regulator works on behalf of the public to police our members. This requires a culture of objectivity and detachment. In contrast, a good membership organisation encourages the creativity and success of its members: and we need to be a closer community and involve our members more.
That’s why we need to separate these conflicting cultures so both sides can flourish. How we do that is a subject for wider discussion.
Free student membership to everyone studying in our training organisations
As I said, we are going to offer everyone studying with our own training organisations, free UKCP membership, including online access to ‘The Psychotherapist’, discounts on our workshops, journals and CPD training and, hopefully discounts on research papers.
With many of our members now approaching retirement, we really need the involvement of the students just as we need to support our retirees.
Let’s do good things!
We are a charity, we can fundraise and there is no shortage of interesting projects that we can do that demonstrate psychotherapy in action. For instance the Caravan at St James Church is a tiny Consulting Room serving the homeless population of Central London. It’s for people who would never trust the NHS. Nigel Hamilton at CCPE started that some 20 years ago. It’s a terrific project that can be duplicated. In Camden Town there are therapists working with gang members out of coffee shops – it’s a brilliant idea. I’ve a plan that could help refugees right across Europe, and I am sure that you have good ideas – let’s choose a few, then the UKCP will go for raising the money to make change happen.
Let’s get together more
Psychotherapy is the most isolating profession. Personally I thrive in a collegiate environment so I want to create more and better reasons to get together – not just for CPD but for support, fun and companionship. I am perhaps best known for starting the Psychotherapy Clubs, which encourage members to put on their own very low-cost events. I want more of that, whether it’s Starbucks meetings or larger low cost-events. We have plenty of great speakers and facilitators and our members have fascinating tales to tell. I want to encourage members to become speakers, writers, bloggers, broadcasters and organisers. In other words – people who promote psychotherapy.
Thank you for reading: I hope I have your support.