Understand the past, embrace the present, enjoy the future

GEOFF BOUTLE
BACP Senior Accredited Counsellor

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Counselling - Change or Conformity?

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All progress depends upon the unreasonable person.

That provocative comment came from the pen of George Bernard Shaw. A skilful wordsmith, Shaw was particularly adept in producing this type of challenging observation. 

This aside comes at the end of a passage in which Shaw growls at conformity. He seems to be suggesting that most people try to fit their behaviours to that which the world expects.  There is a default position of needing to conform. As a result, those who try something different and go for change can sometimes appear unreasonable. Yet so Shaw argues, it may only be by the efforts of these unreasonable people that change occurs. 

As far as validation of Shaw’s assertion is concerned, there are tangible examples all around us. Within this world of psychotherapy and counselling, there are a myriad of instances both historical and contemporary.  For example Freud’s apparently unreasonable insistence in talking about sex to an uncomfortable nineteenth century Vienna provided the lever to prise open consideration of the unconscious when the traditional focus around personal dysfunction had been on establishing physical cause and effect.

Travelling forward a hundred years or so, we can identify a similar phenomenon. The movement of evidence based fundamentalists in enthusiastically supporting all things CBT, developed in part because of the rigid conformity of existing therapy.  Traditional therapists refused to voluntarily step out from under a manufactured cloak of intellectual superiority.

There was a general conformity to an approach which assiduously avoided seeking any empirically based justification to support long term work with clients.  Hence those who did want to embrace the idea of evidence needed an alternative path. That resonated with organisations which expected to be provided with evidence to support funding requests and a new conformity emerged.

Now there are different calls being made.  It is the evidence based fundamentlists who in turn look aghast at the unreasonable demands of those who are increasingly vocal in their criticism of this so called medical model. The long term benefits for clients of this seemingly formulaic model of counselling are now questioned. Some protagonists increasingly see broad emotional development and self-actualisation as more important for the ongoing wellbeing of many individuals than a strict adherence to the homework of completing forms and journals.

My preference is to celebrate variations and difference.  We should certainly resist the attempts to shoe horn everyone into conforming and behaving exactly as opinion formers in society expect. There is something surreal in the expectation that we must be happy at all times and that the only emotionally healthy human face is the one which shows a perpetual smile.

Progress depends upon not only the unreasonable person but perhaps also the critical person. She or he who does not accept things as they are can be a valuable driver for change even if that means being unconventional and risking unpopularity.  Populist sentiments reflect just a moment in time.   A headline position taken by a leader writer on a moral issue may be no more than an expression of contemporary fashion, frozen in the cold grip of self-appointed public guardians.

In historical terms, shrill voices rarely provide a well-founded reflection of universal values. Fashions come and go. The world of psychotherapy has certainly seen many trends often championed by an articulate advocate.  The leading lights of the counselling world over the last century reflect these different perspectives. Some were visionaries, several were conformists and perhaps others were just disruptive.  But perhaps certain of those disruptives were able to reach the parts that the conformists could not.  R D Laing may be an obvious example.

Laing was a psychotherapist of the sixties. Undoubtedly a product of that time, he was feted and admired by the would-be avant-garde; and also heavily criticised and shunned by others within the therapeutic establishment. He was a radical, an enfant terrible of the therapy world.  Seen by some as almost dissolute, there are many stories about his practice and his way of being which were and indeed still are looked upon through a prism of severe disapproval and yet…..    

One well known story is that Laing encountered a young female patient in an mental hospital who had been diagnosed as a schizophrenic. She was curled up in a corner, without clothes, ignoring would be carers and refusing to communicate with anyone. Laing undressed, went into the room and sat beside her. This troubled and isolated patient eventually responded. There was some form of identification. She started to speak and to engage with Laing and so the narrative goes, there was that first sense of unlocking and of being with another.

I have to quickly add that this is not a practice I follow, nor one that I am advocating for others. Indeed, in the present climate we can anticipate what the response today would be to similar actions by a contemporary therapist.    

Banishment would be absolute, savage and swift. The world of the outraged would delight in an outpouring of vilification. The practitioner would be publicly dragged through the public mire before being professionally disembowelled on the altar of the relevant ethics committee. Laing or any other (male?) therapist risking such an experimental approach now, would be up in front of magistrates and accrediting bodies before we can say ‘ red tops’.  And the unfortunate patient would either be surrounded and swamped by those who will always know best or alternatively and perhaps more likely when all else had failed, be left alone, curled up and isolated. 

That determination of the conformists to search out and condemn any who do not adhere to the current norms of public behaviour has other examples in different sectors of the western world.  Consider the political arena.  Any mainstream Western politician, who seeks a favourable press, will want to be heard condemning excessive business profits, criticising bonus payments to executives and being outspoken in the support of workers’ rights both home and abroad.

Yet if we transport ourselves to perhaps the US in the early nineteen fifties, what would have happened if we talked publicly of such things then. Senator Joe McCarthy would have been loudly apoplectic and our employment prospects in certain US states would be in shreds as we were denounced as a closet enemy of the free world.

There is an obvious example with regard to issues of morality.  In terms of sexual mores, less than a century or so ago homosexuality was viewed as the unspeakable depravity. It was seen by many in the then establishment in the same way as paedophilia is today. If that seems an exaggeration, take time to reference back to the media coverage of the day.  The ‘name that could not be spoken’ was a label used to vilify and condemn those who behaved differently.

Yet now the stamp of legality has established enforceable gay rights. Those who would criticise are now themselves outside the law and same sex marriage is embarking on what seems like an unstoppable march into the statute book with the backing of all political parties. The Oscar Wildes who were sent to languish in Reading gaol and exiled to die in a foreign land have now been replaced in public odium by whoever is the latest celebrity name to be associated no matter how remotely with issues such as those emanating from the Saville scandal.

Fashions change, values change and morals change.  If we want to avoid the denunciation of the contemporary thought police we must stay ahead in the game of acceptability. If we wish our reputations to remain intact, we need to think forward. Conformity demands crystal ball gazing and it must be accurate. Just ask those police and journalists who had previously understood that it was perfectly okay to share information and expense accounts and who are now facing prison, condemned by those who had turned a blind eye to what was known to be happening.

So what is more important? Our reputation or our actions? Should we always look to fit with the demands of the moment or adopt a longer time perspective? Is a good life one which always stays within the bounds of public acceptability and never dares to wander?  Is it right that a rigid conformity to current norms should dictate what we do and how we act.  Should we unquestioningly accept the injunction of orthodoxy which demands adherence to that which the current group of self appointed custodians of contemporary public morality and business ethics say is right?

And what is the relevance of these thoughts to the counselling world?  The guardians of that which is reasonable, would today often appear to be those who control funding. And funding demands an evidenced based conformity and not innovation. Counselling and therapy must fit with that which is expected.  I wonder what the likes of Laing would make of that drive for conformity.  More importantly I also wonder about the benefits for each individual client.

My concern is that what is a reasonable way of working for one person may not accord with the requirements of another. That approach which enables one person to benefit from the time spent within the counselling room, may not match the needs of someone else with a very different outlook on life.

Although those who encourage globalisation may growl at the prospect, we still remain (just?) as individuals with the freedom to choose.  That is true of counselling as with any other product.  The client may prefer to work with a structured approach such as Cognitive Behaviour Therapy (CBT), with a results focused technique such as Solution Focussed Therapy or with a deeper and more reflective modality such as Psychodynamic Counselling – and each client should remain free to make that choice assuming of course that there is some understanding as to what the different strategies offer.

Similarly we as practitioners should hold fast to the freedom to offer support in the way which we feel is right for each individual who sits with us. On occasions that can mean that we have to reach into the toolkit to produce something which may not always conform to that which the counselling establishment would recognise.

Whether the subsequent interaction is reasonable or not, should be a decision to be made by the consumer and practitioner, not the observer. If the two parties directly involved, the client and the therapist regard the approach, the action or the intervention as appropriate in the given circumstances, then that should usually be sufficient. Of course there must be always be robust and effective safeguards to protect the vulnerable but these requirements should be proportionate and not become a blanket to stifle creativity and innovation.

Clients walk into a counselling room because there is a need for some form of personal change. That change can come from moderated, well tested approaches but for some more challenging situations, change may be more difficult to achieve.   On those occasions we may well need to think outside that which the conformists see as appropriate. We may wish  to look instead at ways of working which cut across established processes.

Some will always question whether such an approach is acceptable but for certain clients, progress may indeed depend on that which is unexpected and challenging.  If the cloak of conformity is too stifling to permit this then it should be thrown off and discarded. In therapy the needs of the client are paramount. If it should be in the interest of the individual client then the therapist should always be prepared to be unreasonable.

I wonder if somewhere in the great beyond  Mr Shaw may just be nodding in agreement…….!

 

 

 

By
Geoff Boutle

added on 1st June 2013

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