CORRESPONDENCE

The Fallacy of the `Core Profession'

One of the most insidious fallacies about psychotherapy is that it is based on certain `core professions', and that therefore people should qualify in one of these professionsbefore they can receive further training as psychotherapists.

The three professions usually mentioned in this context are psychology, medicineand social work. It seems to me that there are serious objections to all of them. Medicinetrains people to treat the person like a complicated machine, and social work is tooclosely tied in with issues of social control. But psychology is the one with which I ammost familiar, so I will leave it to others to make the corresponding arguments in thoseareas.

There is of course a certain superficial neatness about the idea of a core profession. Ifit could be established that there was a particularly suitable preparation offered by anexisting profession (or three), this might overcome the obvious objection that such anapproach is extremely narrow.

Let us therefore look closely at the preparation given by psychology as taught inexisting degree courses at prestigious universities.

The first thing we notice about academic psychology is that it aspires to scientificobjectivity. It was a triumph of the British Psychological Association that psychologywas in recent years admitted to the pantheon of true sciences in the internationalcommunity of scientists.

Now the whole point of scientific objectivity, as taught in academia, is that it enablesthe scientist to stand well back from the phenomena being studied, and not allowsubjectivity to spoil the work. The apotheosis of this approach is the controlledexperiment where we know what the result means because we have strict control over allthe elements involved.

All other methods of studying phenomena are regarded as less valuable than this.Only the controlled experiment gives genuine knowledge because it is only the controlledexperiment which eliminates alternative explanations of the phenomenon being studied.

The philosophy behind this is basically Aristotelian, laying emphasis on formal logic,determinism and causality, relabelled as dependent and independent variables.

For example, a typical modern textbook says this sort of thing (and so do others,quite regularly) in the first chapter (Rubin & McNeil 1987):

In contrast [to personal experience], psychologists strive to study behaviour in ways that aresystematic (based on a thorough and well-organized search for facts) and objective (based oncareful measurements that different observers can agree on, rather than on one person'sintuitions).

And in case it should bethought that this is specially selected and American (mostpsychology textbooks are in fact American), here is a rather ordinary British version ofthe same thing (Lloyd et al 1984):

The science of psychology seeks to advance and test hypotheses ... It does this by usingcontrolled experiments, to see how variables affect behaviour, and self-reports of what isperceived, thought, remembered and felt.

British Journal of Psychotherapy, Vol. 7(1),1990© The Author

Correspondence 95

These are not specially selected books, simply the first two which came to hand.This emphasis on objectivity means that the psychologist is trained to stand outside

the phenomena being studied and to regard them as things to be manipulated, in such away as to yield the maximum of tested knowledge. Every now and then the psychologistgoes too far, and there is an ethical storm over whether human beings should be treatedin such a cavalier way. The example which sticks in my mind is one where theexperimenter injected the experimental subjects with a drug which stopped their heartsfor thirty seconds. He wanted to study fear without inflicting pain.

Incidentally, it is strange to me that people are referred to as experimental subjectswhen they are so obviously being turned into experimental objects.

What do psychologists study?

One might think, in one's innocence, that psychologists studied people. However,studying people brings great difficulties for psychologists because people often resistbeing treated as objects and want to have some say in what is done to them. Thisthreatens the objectivity which is so important because they might influence the resultsby their wishes.

In the 1960s psychologists got around this problem by concentrating on studyinganimals: the laboratory pigeon, the laboratory rat, the laboratory squirrel, the laboratorymonkey or ape in some bold cases. But in the 1970s there was so much criticism of thisby radical psychologists and others that it had to be given up. What to do?

The first answer which occurred to psychologists was to study babies. Here wassomething recognisably human but which had the inestimable advantage that it could nottalk back and influence the results in any illegitimate way. And so we got the enormousplethora of studies on very young babies which has in fact been very informative and hasgiven us a much greater respect for the maturity and powers of the new-born baby. Butwe were as far away as ever from what the ordinary person would regard as the provinceof psychology proper.

However, it soon appeared that babies were still too problematic, too prone tointroduce complications of an unforeseen kind, to be fully controllable. So the search wason for something new and better.

It was found in the shape of the computer. Computer technology had advanced to thestage where instead of it being something arcane and specialised, every home had one.Research became much easier and new discoveries were possible. All that was neededwas someone to make the connection between computers and the human being, and hugestrides could be made.

This came in the shape of cognitive psychology. In the 1950s cognitive psychologyhad been a humanistic study mainly pursued by Germans and generally disapproved ofby Americans. But the new cognitive psychology, based on computer models, wasobjective in the extreme. All the variables could be strictly controlled - it was anexperimenter's paradise. And so we have people nowadays talking about cognitivescience and the cognitive revolution.

Some years ago I went to a university in the Midlands to give a talk on humanisticpsychology, and afterwards got talking to the professor (who shall be nameless to sparehis blushes) and some of the senior students. At one point we got talking about models ofthe person, and I asked the professor what his model of the person was. He said: `The

96 British Journal of Psychotherapy

computer'. I questioned this - surely he could not really mean that? But he maintained thepoint, and some of the students confirmed that this was indeed his considered view.

This is madness. It is an enormous insult to human beings to liken them tocomputers. If we think of the four functions mentioned by Jung, which everyone has -sensing, thinking, intuiting and feeling - it is obvious that computers can do the first twoof these to some quite impressive extent, but that the second two are quite beyond them.So no matter how much we studied computers, we would only be studying half a humanbeing, or part of a human being. There is more to life than information processing.

And psychotherapy?

Now the question is: can a science like this be anything like a core discipline forpsychotherapy? I would say it is actively opposed to what we are trying to do inpsychotherapy.

It seems to me that psychotherapy is about doing justice to subjectivity and not aboutavoiding it. Somehow we find ways of making one person's subjective experience moreunderstandable, more to be coped with at the very least. And probably most of us thinkthat we have to use our own subjectivity in the process.

Surely a training in psychotherapy is a training in disciplining our own subjectivityso that it is more reliable, more usable, more experienced in a variety of ways? It is by nomeans a training in removing or eliminating it.

Even more obviously - and here I do not think it is question of opinion but one of fact- psychotherapy is about dealing with the whole person, not half a person, or part of aperson.

Psychology seems to lurch from one terrible simplification to another. I see that thelatest research seems to suggest that people really only need two therapy sessions (plusone later follow-up), and that anything more is less cost-effective. This is the sort ofnonsense which one can get to by trying to be super-objective.

This essay could be extended and amplified much further, with the copious quotingof references, but I think enough has already been said to make the main case.

I do not want to be seen as saying that psychology would be all right as a coreprofession if only it would be more open to subjectivity, say along the lines of newparadigm research (Reason & Rowan 1981). What I am trying to say much more is thateach of the supposed candidates for core profession is too narrow in its own way. And bybeing so narrow, they actually militate against psychotherapy as a discipline, which isitself not narrow at all.

And I would suggest that parallel arguments would rule out medicine or social workas being any better as `core professions'. But that is for others to argue.

John Rowan

References

Lloyd, P. et al (1984) Introduction to Psychology: An Integrated Approach. London: Fontana.Reason, P. & Rowan, J. (Eds) (1981) Human Inquiry: A Sourcebook of New Paradigm Research.

Chichester: John Wiley.Rubin, Z. & McNeil, E.B. (1987) Psychology: Being Human. New York: Harper & Row.

Correspondence 97

On Acting Out in the Countertransference

I want to thank Joan Schachter for the thoughts she expressed in her review ofChristopher Bollas's Forces of Destiny in this Journal, (6(3)). By the way she pulledtogether what she saw as the central points I had one of those celebratory `AHA'experiences. Now I'd like to comment on it. It is the idea of a free act in an experience ofencounter. I am a newly qualified analytic psychotherapist who often feels like a carwithout a proper make. I do not sometimes know who to belong to, which school, which `mast' do I nail my heart to? I know certainly that two of my `of the essence' papers fromanalytic practice are the two that Schachter referred to. When I first read Symington's andColtart's papers they were to me like sweet smells of fresh air, sunshine on my shoulder,etc. I wondered why they were not required reading in training. They describe free actswhich can be understood and cherished as just that. It is confusing to me that often suchacts are labelled `acting out'. The label turns a form of human intimacy into a destructive `you need more analysis' deed. (In fact I wonder if people reading this commentary willthink the same of me!) I am not saying that there is not such a thing as `acting out'. And Irealise that this topic which I am touching on is complex and needs very carefuluntangling but I am at the beginning. It seems to me that all too frequently basic humangestures are too easily lumped into the category of `acting out'. Such sensitivespontaneous acts of analytic practice seem to be so suspect. For me what is suspect is atoo rigid analytic stance. Could one ask if the stance could be an `acting out'? A way ofcontrol, of keeping everything within a talking framework; is it out of an unspoken `keeping in' with The Elders, The True Ones, The Heritage? In the presence of suchillustrious Ones I wonder if there is room to play, if there is room to find, to be aware ofhuman interactions which are closer to realms of performance, of gesture, of sound, of thenonverbal. I would ask readers, the editor, writers, for some feedback on this topic of theboundaries around `acting out', gesture, acts of play, acts of sensitivity within the analyticframework ... other papers, articles, books -material for a closer look into the matter.

Carlotta Johnson

98 British Journal of Psychotherapy

Psychotherapists Against Nuclear Disaster

Dear EditorPAND continues its task of keeping alive and public the contribution that

psychoanalytical thinking has to make to issues of war and peace, both by meetingtogether, and by offering workshops or groups to large conferences on disarmament andrelated issues. We have made links with other professional groups using their skills tofurther understanding in this field.

PAND members ran a large group at the Medical Campaign Against Nuclear Armsconference last autumn and home groups are being organised at this year's Symposium -Health and Security 2000 - New Thinking in Europe. This marks the 10th Anniversary ofthe Medical Campaign and International Physicians for the Prevention of Nuclear War.Links have been made with SPINA (Study Group for Psychosocial Issues in NuclearArms) and PWDD - Professions for World Disarmament and Development.

Our Autumn workshop with Scilla Elworthy, Director of the Oxford Research Group,had as its theme - The Decision Machine - and focused on the attitudes and assumptionsof decision makers in the field of nuclear arms.

New members are very welcome and should contact the Administrative Secretary on071 928 5747.

Diana Priestley