Demystifying Therapy

P1010199You guys, I’m nearly a counsellor, or therapist, or whatever [lesson #1: there’s no difference between therapists and counsellors, but you can tell a lot from which label they choose. I prefer therapist, because it makes me sound clever and deep and possibly magic and a little bit medical and so proper and so better than the jumper-wearing woolly-minded do-gooders who call themselves counsellors].

So anyway I’m nearly a counsellor, in that I’m nearing the end of a year of lectures and training on and in counselling.

But in fact, as far as the law is concerned, we’re all nearly counsellors. We any of us can put a plaque up above our door, knock up a profile on a counselling website (complete with heavily-censored profile pic) and start charging money for our counselling services. Initially this lack of regulation troubled me: if anyone can set up as a counsellor, how do I know the guy I’m spilling my guts to isn’t a charlatan. How do I know he isn’t just some guy who reckons he knows something about the world and the people in it? And if he is just some guy, how can I be sure he won’t get things wrong, misunderstand me, give me the wrong advice, trample all over my fragile self, and all that?

But the more I learn about counselling the more I like the lack of regulation. (To be clear, there is a regulatory body (the BACP) who ensure that certain standards are adhered to. They require a certain level of practice and qualification and all of that, but it’s not statutory. Most organisations require you to be a member if you want to work for them, but you don’t have to if you want to set up in private practice.)

The name of this post is the name of a very good book about therapy by a very good man called Spinelli. If you’re at all interested by what I write you should read it. It’s long mind.

Why do I like the lack of regulation? Because ultimately all of us therapists and counsellors are charlatans. We none of us know any more about motivation, emotion, conflict, desire, love or despair than anyone else. We may have spent more time thinking about these (or we may not, despite the training), and may (or may not) be more open to engaging with them without following the urge to flee to safer territory, but our theories and frameworks are no closer to the truth than yours, or hers, or his.

Realising this came as a shock to me. I had entered the profession apprentice-like, expecting to find a theoretical home that would be based on solid foundations. I wanted to find the theory which uniquely amongst all others captured the nature of human suffering, and told me how to help people who were suffering suffer less. And there’s plenty to choose from: a figure often bandied about is that there are over 400 types of therapy available, each with it’s own foundational theory of human nature and wellness.

The problem is, of course, they’re all lies. Not deliberately (well, not all of them), but they’re all lies. And the idea that the therapist practices out of these foundations is a lie too. All the theory does is helps the therapist feel more confident, gives them less to worry about (because it focusses their attention on specific utterances or dynamics), and gives them a tool with which they can dominate the client. I still hate the term ‘client’, despite having used it dozens of times every day for a good 6 months now. But this is what you are, if you see a therapist. A client. In that name are contained all of the assumptions (lies) about professionalism, expert status, and product purchase. And the problem with this is that, well, it’s not a problem. It can be very useful to believe that your therapist is an expert, or a little bit magic. As a client I’ve experienced this a few times, and without that faith (which, in secular times must be based on status, or the authority of regulatory bodies) I would not have got anywhere near so much out of the work we did.

P1010227But it’s still lies. What happens in therapy is that two people talk to each other for a bit. This is all. It’s just like talking to your friend. It’s just you’ve paid them to be your friend. It feels taboo to say this, but therapists are, like your man ‘someone’ says, essentially prostitutes without the sex [I think it might be Masson – he’s fun]. You pay them to sit with you and talk. They might, like some friends might, just listen and give you space to ‘let it all out’. They might, like some friends might, link your current problems to past problems, or to ways of thinking that, to them, seem strange. Or they might, like some friends might, tell you about this great technique they’ve heard about to help you get out of the self-destructive spirals you find yourself in. Or they might, like some friends, do something completely unexpected.

P1010236You can choose to go and see your solid, safe friend, the one you’re fairly sure will sit back and won’t impose or diagnose or interpret you (person-centred). Or you can choose your problem-solving friend who doesn’t seem comfortable dwelling (he’d say wallowing) in the emotional shit, but always motivates you to get things done (CBT, SFT, coaching). Or youmight go to your perceptive friend who always has a different perspective, but who you worry has a bit of an axe to grind about something to do with his mother or death or something (existential analysis, psychodynamics). Knowing what these friends are like provides a little safety, but not that much. Each of them knows that their theories are lies, and that it’s often (always?) more important to follow their gut, or to let the relationship lead them. In fact, this is written in to some of their theories.

P1010205So, how can I know that my therapist won’t get things wrong? How can I trust that I can let down my barriers and open myself up without being fucked up by some two-bit snake-oil merchant posing as a sage? I can’t. And regulation won’t do it either. Your man Attlee said something nice about trust: “It is a fundamental fallacy to believe that it is possible by the elaboration of machinery to escape from the necessity of trusting one’s fellow human beings”. He’s right.

Realising that therapy is just two people in a room, talking (or not talking), has been liberating for me. It’s not ‘just’ paid-for friendship, it is paid-for friendship. Friendship is amazing, and terrible. It is mundane and transcendent. It is harmful and healing. Ultimately, no amount of theories or regulations can protect clients from the fact that walking into a counselling room is as risky as entering into any close relationship. Just as risky, but with just as great rewards. Within the therapeutic relationship you may be completely misunderstood and further isolated, or you may make incremental or paradigm-shifting change which reconnects you to yourself and the world.

The factors which decide between these outcomes, and the many shades of grey in-between, are not known. Each school has it’s own ideas, but they’re all, I’ll say it again, lies. Nice ones, mostly. But lies nonetheless. There is no theoretical machinery, no matter how much we might research the micro-processes of human interaction (and this is where the hot research in counselling is right now), that can get over the need to trust another human being.

At its best, and at its worst, therapy is human. This is all.

PS. The photos here are all ones that I took on the way to, or on the way back from, therapy sessions. 

2 thoughts on “Demystifying Therapy

  1. Sweet. I’d still rather pick a therapist who has met her demons and played chess with them, or at least badminton, than one who hasn’t. And there’s no knowing that until you get in there, and see how much of your stuff she runs away from, or magically mishears.

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