Reactions
Therapy Today, October 2023

Your feedback on Therapy Today articles

I really hear Louise Wilson’s call to arms and am responding as such (‘A call to arms for person-centred therapists’, Therapy Today, July/August 2023). As a person-centred (PC) counsellor for more than 10 years now, I am tired of almost bashfully announcing I am PC, ready to defend or to show evidence of how the approach works, in the shadow of more ‘effective’ stances. I am no longer willing to apologise for my modality and philosophy.

The PC approach has been boiled down and reduced to the ‘core conditions’ over recent years, completely devaluing all the writing and research into this philosophy and theory, and turning what are ways of being in therapy to a set of tools to be used as and when the counsellor sees fit. This is where the approach becomes passive in my opinion, a major criticism of the modality recently – of course clients will experience it this way if a counsellor is using empathy as a ‘core tool’ by simply reflecting what has been said without any of the other relational conditions at play. I would say PC practice reduced in this way is not PC practice but something else, something butchered and streamlined for efficiency.

To add to the many references in Louise’s article, there is also Rogers’ idea of processing, and his seven stages of process, a clear piece of theory around client development. Again, without immersion in these early theories and research by Rogers, and a commitment to offer a therapeutic relationship based around the six conditions of therapy as a way of being, the PC approach is not complete, and therapists applying the ‘core conditions’ as tools are not offering clients person-centred therapy.

I agree that the PC approach remains radical in its philosophy for the reasons Louise mentions, particularly in the current climate, where treatment for ‘disease’ is once again becoming a dominant political force for those who are vulnerable, on the edges of society. We need to keep reminding the field and colleagues exactly what it means to have the intention of offering PC therapy to a client in its most potent offering, with all of the above at play.

Scott Reeve MBACP (Accred), counsellor, supervisor and sessional lecturer at Keele University

Next in this issue

Person-centred

Louise Wilson’s article ‘A call to arms for person-centred therapists’ (Therapy Today, July/August 2023) warns that person-centred philosophy is in danger of becoming nothing more than a historical footnote.

After completing my training in the UK in 2019, I returned home to Israel to find that person-centred therapy and the humanistic approach in general are already a mere anecdote in most therapy studies here. Psychoanalysis and the psychodynamic approaches are at the top, with CBT and its derivatives a close second place. I was sad to learn that humanistic therapies have nearly no mention in the local therapy community.

I was however comforted by the thought that at least in the UK and other parts of the world, person-centred therapy was still going strong, and I am deeply saddened to learn from Ms Wilson’s article that this is not the case.

In a society increasingly polarised, do educated and enlightened therapists no longer trust clients who may think differently? Or is it too much work to be led by the client, rather than by the therapist’s educated interpretation? The ‘third force’ in psychotherapy emerged as a reaction to the psychoanalytic and behavioural approaches. What, then, is the diminishing of the approach a reaction to? I would genuinely welcome an exploration of this.

Rachel Kaminetsky MBACP

I found Louise Wilson’s article a refreshing read. Having trained in the model, I passionately believe that person-centred therapy (PCT) is invaluable. We live with a constant bombardment of directives rooted within an expert/subordinate communication style. Not only is this prevalent in modern medicine but pretty much every area of life. PCT gives clients a sense of power that is taken from them day in, day out. Giving the client the time, space and environment to strive towards self-understanding and growth is an act of defiance in a world that tells each person how to live their lives.

Jodie James, BACP student member

I agree with a lot of what Louise Wilson says in her defence of the person-centred approach. It’s particularly alarming to see how the approach is being reduced to three core conditions and then co-opted into other modalities as if the person-centred approach alone doesn’t really cut it anymore.

However, I can reassure Louise that not all counselling courses taught at universities exclude the person-centred approach. At Keele University studying for a PGDip in Counselling and Psychology I gained a very experiential and creative approach to ‘being with’ another in therapy. The course grounded us in Rogerian non-directivity and that ‘the core conditions are all that is necessary and sufficient for therapeutic change to occur’. Approved prior learning was also taken into account during my time there, so higher education was within the reach of those from non-academic backgrounds.

I do hope Louise’s well-written piece helps to energise and engage the person-centred community to continue to do what we do, which is putting the client first and providing an antidote to the medicalised approach offered elsewhere.

Andy Lawton-Collins MBACP

Neurodivergence competence

I agree with Alison Smith that being misunderstood in therapy does reinforce the trauma of being misunderstood by society at large (‘Reactions’, Therapy Today, July/August 2023). I trained to become a counsellor after struggling to find appropriate mental health support for my son with someone who understood the nuances and individuality of autism. Understanding neurodivergence has become a lifelong passion of mine. In my practice I have clients who are autistic or think that they may be. Some have had counselling before but felt the counsellor didn’t understand autism and the counselling just went round in circles. It is our responsibility as counsellors to equip and train ourselves to help our clients, but I have seen from the perspective of a parent the harm that is inflicted when someone says they have competence to work with autism yet don’t then have the skills. We must keep the Ethical Framework in mind and work within our competence.

Susan Aston MBACP

Psychedelics

I read ‘Is working with psychedelics the future of therapy?’ with much interest (Therapy Today, July/August 2023). At the same time, I am finding myself concerned about the position of BACP to dissuade any member from using the term ‘psychedelic’.

As a psychotherapist and member of BACP, I am involved in two major psychedelic research studies with two different research organisations. Both studies received UK Government clearance and permission, and one of these studies is largely funded by the Government.

My role as a psychotherapist is to guide research participants towards their psychedelic dosing experiences, which form the main part of both studies. Afterwards, I help participants with the integration of this experience. The whole infrastructure of the studies as well as all communication about my role include the term psychedelic. In short, my role is that of a psychedelic research psychotherapist. There is no way to describe my work without using the term psychedelic as this would be unscientific or even misleading.

Apart from myself, a considerable number of psychotherapists work in this field, all needing to use the term psychedelic to accurately describe what they do. You find their names under publications, on course materials, on websites of renowned international institutions or as graduates of courses that are dedicated to psychedelics. The term psychedelic is widely recognised, which makes it necessary for many psychotherapists to use it.

Dr Werner Kierski MBACP (Snr Accred)

Catherine Jackson’s article outlining recent clinical research into the therapeutic efficacy of psychedelics offers some much-needed hope for both the overburdened mental health professions and, most importantly, those suffering from ‘intractable and disabling mental health conditions’.

Her article discerns an ‘irony’ and, indeed, immorality in the enforced hiatus between comparative clinical research conducted in the 1960s and today’s promising evidence base. As Catherine elaborates, this was a direct result of these substances being comprehensively rescheduled and legally prohibited according to each country’s classification systems. This meant a closure of clinics and the cauterisation of research for five decades.

However, the article neglects to state why ‘the 1973 Misuse of Drugs Act halted research into their medical use’. The answer to this lies in negative association with the ‘hippy’ counterculture movement which was, for the US establishment in particular, deemed a threat to society and the way of life at the time. Inflamed by the media, this fusing of psychedelic drugs with hedonism, delinquency and subversion created a stigmatisation that remains deeply ingrained in our culture.

How disappointing then to see that Therapy Today has, on the cover and in the article, elected to wrap the discussion in anachronistic and trivialising graphics that reinforce the very associations that created and fuelled the ongoing battle to legitimise research. Suggesting a synaesthetic dreamscape, complete with magic mushrooms, smiling flowers and opening doors, the image comprises a roll call of tropes and stereotypical representations of a recreational or spiritually curious ‘trip’.

The rapidly increasing sophistication of technology means we now understand these drugs at a molecular level, and we can demonstrate the effects on participants with more certainty than ever before. In other words, this is a new generation of drugs aimed at future generations of individuals whom, as the article states, are in desperate need of viable options. The optics around the emerging contribution of psychedelic compounds to mental health pharmacology need to reflect a serious science base in order to attract and reassure both professionals and clients.

Sarah Glen MBACP (Accred), psychotherapist and supervisor