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Here now is a better developed and researched article from The Times.
But the fact that these themes are getting public attention on this scale suggests the possibility that the British public world – at any rate the chattering classes (will this filter down even to The Sun?) has woken up to the existence of Psychotherapy!
That could be a good thing and it could be pretty scary. Because in the harsh light of national publicity it is difficult to get a handle on the nuances, on what those arguments are about which have so long troubled the profession!
Jason Wright is quoted in the Times article in a way which puts an accurate finger on aspects of the problem.
Jason Wright, of the Association of Independent Psychotherapists, who ran an addiction clinic for 12 years, sees a broader tension in the culture between subjectivity and objectivity with subjectivity or personal experience losing out. In the NHS today randomised controlled trials are the gold standard for evaluating treatment. In practice, clinicians fall back on their judgment, a blend of experience, observation and opinion. Is it this that a controlling, centralised, paranoid state finds intolerable?
Well without going all the way down the road with the ‘controlling, centralised, paranoid state’, which may not be from Jason at all (here is one of those ‘nuances’) we can certainly say that the contrast Jason formulates in terms of ‘objective’ and ’subjective’ is relevant. In recent discussion some of us from the Humanistic and Integrative Psychotherapy Section (HIPS) had with members of the Skills for Health Strategy and Reference Groups the issues certainly were organised around the question of a rule-governed and sequenced set of prescriptions as a model for analysing intervention versus a much wider conception, which takes account of the fact that there is a unique individual process in every psychotherapy (and counselling) session .
In fact Charles Dickens analysed this long ago, in Hard Times! And some of what we are up against is – not to put too fine a point on it, – Gradgrindery. But our experience of the Health Professions Council has not been that they think in a Gradgrindish way, and there are plenty of people represented even within Skills for Health who are open to a much broader position. Some of this is Government driven, we know. But there is much to discuss yet.
Meantime, let us remind ourselves of how Dickens put the contrast, in Chapter 2 of Hard Times !
Chapter II — Murdering The Innocents
THOMAS GRADGRIND, sir. A man of realities. A man of facts and calculations. A man who proceeds upon the principle that two and two are four, and nothing over, and who is not to be talked into allowing for anything over. Thomas Gradgrind, sir — peremptorily Thomas — Thomas Gradgrind. With a rule and a pair of scales, and the multiplication table always in his pocket, sir, ready to weigh and measure any parcel of human nature, and tell you exactly what it comes to. It is a mere question of figures, a case of simple arithmetic. You might hope to get some other nonsensical belief into the head of George Gradgrind, or Augustus Gradgrind, or John Gradgrind, or Joseph Gradgrind (all supposititious, non-existent persons), but into the head of Thomas Gradgrind – no, sir!
In such terms Mr Gradgrind always mentally introduced himself, whether to his private circle of acquaintance, or to the public in general. In such terms, no doubt, substituting the words ‘boys and girls,’ for ‘sir,’ Thomas Gradgrind now presented Thomas Gradgrind to the little pitchers before him, who were to be filled so full of facts.
Indeed, as he eagerly sparkled at them from the cellarage before mentioned, he seemed a kind of cannon loaded to the muzzle with facts, and prepared to blow them clean out of the regions of childhood at one discharge. He seemed a galvanizing apparatus, too, charged with a grim mechanical substitute for the tender young imaginations that were to be stormed away.
‘Girl number twenty,’ said Mr Gradgrind, squarely pointing with his square forefinger, ‘I don’t know that girl. Who is that girl?’
‘Sissy Jupe, sir,’ explained number twenty, blushing, standing up, and curtseying.
‘Sissy is not a name,’ said Mr Gradgrind. ‘Don’t call yourself Sissy. Call yourself Cecilia.’
‘It’s father as calls me Sissy, sir,’ returned the young girl in a trembling voice, and with another curtsey.
‘Then he has no business to do it,’ said Mr Gradgrind. ‘Tell him he mustn’t. Cecilia Jupe. Let me see. What is your father?’
‘He belongs to the horse-riding, if you please, sir.’
Mr Gradgrind frowned, and waved off the objectionable calling with his hand.
‘We don’t want to know anything about that, here. You mustn’t tell us about that, here. Your father breaks horses, don’t he?’
‘If you please, sir, when they can get any to break, they do break horses in the ring, sir.’
‘You mustn’t tell us about the ring, here. Very well, then. Describe your father as a horsebreaker. He doctors sick horses, I dare say?’
‘Oh yes, sir.’
‘Very well, then. He is a veterinary surgeon, a farrier, and horsebreaker. Give me your definition of a horse.’
(Sissy Jupe thrown into the greatest alarm by this demand.)
‘Girl number twenty unable to define a horse!’ said Mr Gradgrind, for the general behoof of all the little pitchers. ‘Girl number twenty possessed of no facts, in reference to one of the commonest of animals! Some boy’s definition of a horse. Bitzer, yours.’
The square finger, moving here and there, lighted suddenly on Bitzer, perhaps because he chanced to sit in the same ray of sunlight which, darting in at one of the bare windows of the intensely white-washed room, irradiated Sissy. For, the boys and girls sat on the face of the inclined plane in two compact bodies, divided up the centre by a narrow interval; and Sissy, being at the corner of a row on the sunny side, came in for the beginning of a sunbeam, of which Bitzer, being at the corner of a row on the other side, a few rows in advance, caught the end. But, whereas the girl was so dark-eyed and dark-haired, that she seemed to receive a deeper and more lustrous colour from the sun, when it shone upon her, the boy was so light-eyed and light-haired that the self-same rays appeared to draw out of him what little colour he ever possessed. His cold eyes would hardly have been eyes, but for the short ends of lashes which, by bringing them into immediate contrast with something paler than themselves, expressed their form. His short-cropped hair might have been a mere continuation of the sandy freckles on his forehead and face. His skin was so unwholesomely deficient in the natural tinge, that he looked as though, if he were cut, he would bleed white.
‘Bitzer,’ said Thomas Gradgrind. ‘Your definition of a horse.’
‘Quadruped. Graminivorous. Forty teeth, namely twenty-four grinders, four eye-teeth, and twelve incisive. Sheds coat in the spring; in marshy countries, sheds hoofs, too. Hoofs hard, but requiring to be shod with iron. Age known by marks in mouth.’ Thus (and much more) Bitzer.
‘Now girl number twenty,’ said Mr Gradgrind. ‘You know what a horse is.’
She curtseyed again, and would have blushed deeper, if she could have blushed deeper than she had blushed all this time. Bitzer, after rapidly blinking at Thomas Gradgrind with both eyes at once, and so catching the light upon his quivering ends of lashes that they looked like the antennae of busy insects, put his knuckles to his freckled forehead, and sat down again.
The third gentleman now stepped forth. A mighty man at cutting and drying, he was; a government officer; in his way (and in most other people’s too), a professed pugilist; always in training, always with a system to force down the general throat like a bolus, always to be heard of at the bar of his little Public-office, ready to fight all England. To continue in fistic phraseology, he had a genius for coming up to the scratch, wherever and whatever it was, and proving himself an ugly customer. He would go in and damage any subject whatever with his right, follow up with his left, stop, exchange, counter, bore his opponent (he always fought All England) to the ropes, and fall upon him neatly. He was certain to knock the wind out of common sense, and render that unlucky adversary deaf to the call of time. And he had it in charge from high authority to bring about the great public-office Millennium, when Commissioners should reign upon earth.
‘Very well,’ said this gentleman, briskly smiling, and folding his arms. ‘That’s a horse. Now, let me ask you girls and boys, Would you paper a room with representations of horses?’
After a pause, one half of the children cried in chorus, ‘Yes, sir!’ Upon which the other half, seeing in the gentleman’s face that Yes was wrong, cried out in chorus, ‘No, sir!’ — as the custom is, in these examinations.
‘Of course, No. Why wouldn’t you?’
A pause. One corpulent slow boy, with a wheezy manner of breathing, ventured the answer, Because he wouldn’t paper a room at all, but would paint it.
‘You must paper it,’ said the gentleman, rather warmly.
‘You must paper it,’ said Thomas Gradgrind, ‘whether you like it or not. Don’t tell us you wouldn’t paper it. What do you mean, boy?’
‘I’ll explain to you, then,’ said the gentleman, after another and a dismal pause, ‘why you wouldn’t paper a room with representations of horses. Do you ever see horses walking up and down the sides of rooms in reality — in fact? Do you?’
‘Yes, sir!’ from one half. ‘No, sir!’ from the other.
‘Of course no,’ said the gentleman, with an indignant look at the wrong half. ‘Why, then, you are not to see anywhere, what you don’t see in fact; you are not to have anywhere, what you don’t have in fact. What is called Taste, is only another name for Fact.’ Thomas Gradgrind nodded his approbation.
‘This is a new principle, a discovery, a great discovery,’ said the gentleman. ‘Now, I’ll try you again. Suppose you were going to carpet a room. Would you use a carpet having a representation of flowers upon it?’
There being a general conviction by this time that ‘No, sir!’ was always the right answer to this gentleman, the chorus of NO was very strong. Only a few feeble stragglers said Yes: among them Sissy Jupe.
‘Girl number twenty,’ said the gentleman, smiling in the calm strength of knowledge.
Sissy blushed, and stood up.
‘So you would carpet your room — or your husband’s room, if you were a grown woman, and had a husband — with representations of flowers, would you?’ said the gentleman. ‘Why would you?’
‘If you please, sir, I am very fond of flowers,’ returned the girl.
‘And is that why you would put tables and chairs upon them, and have people walking over them with heavy boots?’
‘It wouldn’t hurt them, sir. They wouldn’t crush and wither, if you please, sir. They would be the pictures of what was very pretty and pleasant, and I would fancy — ’
‘Ay, ay, ay! But you mustn’t fancy,’ cried the gentleman, quite elated by coming so happily to his point. ‘That’s it! You are never to fancy.’
‘You are not, Cecilia Jupe,’ Thomas Gradgrind solemnly repeated, ‘to do anything of that kind.’
‘Fact, fact, fact!’ said the gentleman. And ‘Fact, fact, fact!’ repeated Thomas Gradgrind.
‘You are to be in all things regulated and governed,’ said the gentleman, ‘by fact. We hope to have, before long, a board of fact, composed of commissioners of fact, who will force the people to be a people of fact, and of nothing but fact. You must discard the word Fancy altogether. You have nothing to do with it. You are not to have, in any object of use or ornament, what would be a contradiction in fact. You don’t walk upon flowers in fact; you cannot be allowed to walk upon flowers in carpets. You don’t find that foreign birds and butterflies come and perch upon your crockery; you cannot be permitted to paint foreign birds and butterflies upon your crockery. You never meet with quadrupeds going up and down walls; you must not have quadrupeds represented upon walls. You must use,’ said the gentleman, ‘for all these purposes, combinations and modifications (in primary colours) of mathematical figures which are susceptible of proof and demonstration. This is the new discovery. This is fact. This is taste.’
The girl curtseyed, and sat down. She was very young, and she looked as if she were frightened by the matter-of-fact prospect the world afforded.
‘Now, if Mr M’Choakumchild,’ said the gentleman, ‘will proceed to give his first lesson here, Mr Gradgrind, I shall be happy, at your request, to observe his mode of procedure.’
Mr Gradgrind was much obliged. ‘Mr M’Choakumchild, we only wait for you.’
So, Mr M’Choakumchild began in his best manner. He and some one hundred and forty other schoolmasters, had been lately turned at the same time, in the same factory, on the same principles, like so many pianoforte legs. He had been put through an immense variety of paces, and had answered volumes of head-breaking questions. Orthography, etymology, syntax, and prosody, biography, astronomy, geography, and general cosmography, the sciences of compound proportion, algebra, land-surveying and levelling, vocal music, and drawing from models, were all at the ends of his ten chilled fingers. He had worked his stony way into Her Majesty’s most Honourable Privy Council’s Schedule B, and had taken the bloom off the higher branches of mathematics and physical science, French, German, Latin, and Greek. He knew all about all the Water Sheds of all the world (whatever they are), and all the histories of all the peoples, and all the names of all the rivers and mountains, and all the productions, manners, and customs of all the countries, and all their boundaries and bearings on the two and thirty points of the compass. Ah, rather overdone, M’Choakumchild. If he had only learnt a little less, how infinitely better he might have taught much more!
He went to work in this preparatory lesson, not unlike Morgiana in the Forty Thieves: looking into all the vessels ranged before him, one after another, to see what they contained. Say, good M’Choakumchild. When from thy boiling store, thou shalt fill each jar brim full by-and-by, dost thou think that thou wilt always kill outright the robber Fancy lurking within — or sometimes only maim him and distort him!
———-
So much from Dickens!
If one reads a very fine and thorough work entitled, intimidatingly, Affect Regulation , Mentalization and the Development of the Self one will find an account of mentalization which supports Dickens – because Fonagy and his colleagues make clear that without learning the counterfactual of the ‘pretend’ realm children cannot develop a fully internalized sense of self.
Whether we can be entirely free of Gradgrindery without going so far as to entertain the conception of a non-manualisable process of therapeutic relationship and intervention, is, shall we say, debateable!
