Reflections on the Future of Psychotherapy

Una Maguire talked to Mary Montaut

Are We Diluting Humanistic Therapy?

Psychotherapy has had to go through a phase of being very inward-looking, until 
it became confident enough in its own identity, and we’re now probably deep into
 a phase of being worried about being exclusive. We may be in danger of diluting 
the Humanistic and Integrative mode or philosophy of psychotherapy, but
 hopefully there seem to be already signs of a reaction to that. People are saying 
that we are in danger of losing our specificity or philosophy or getting diluted to 
the point where it’s hard to see the difference between Humanistic and Integrative
 Psychotherapy and Psychoanalytic or other approaches. People are revisiting the
 inspiration and the philosophy and the humanism of Maslow and others.

The other dynamic that I see is the whole question of status and becoming 
business-like: we are spelling things out – part, I suppose, of the definition piece -
 and reacting to fright and worry and insecurity. There can be legitimate and really
 important concerns, but this process can go into a kind of overdrive and become
 too controlling and too stiff, trying to legislate for every thing and losing contact
 with the basic premise of Humanistic and Integrative Psychotherapy, which is trust 
in human beings and in relationship. The IAHIP needs people who will just keep 
reminding us about this in the running of the organisation.

Dividing Lines

Clarifying the dividing line between one kind of psychotherapy and another is one 
aspect of this stage of psychotherapy, and another is the dividing line between 
psychotherapy and other services of humans, individual or in relationship. I would
 look forward to a greater collaboration and a greater understanding between say, doctors and psychotherapists, between psychotherapists and social workers and
 other para-medical professions – solicitors maybe. Other professions could be
 allies, and should be really. We had a meeting at the Institute with people in these
 professions, like doctors, nurses and social workers, and it was heartening to meet 
these people and to hear of their growing appreciation of the contribution of 
psychotherapy and counselling to people’s well-being. This is especially important
 because sometimes doctors may mistrust counsellors and even warn their patients
 against lengthy therapy.

Body Chemistry

And then on the other side. I think that it is no harm at all for psychotherapists to 
familiarize themselves with the contribution that medication can make to the well-
being of a client. That may be rather a dangerous thing to say, but as a 
psychotherapist who has always had tremendous interest in our body as the vehicle
 of our emotion and thoughts and relationship and spirit, I acknowledge that even simple bio-energetic exercises are effecting a chemical change, in our bodies and it 
may be that the chemists can move closer to the provision of chemical 
supplements, or something that would be similarly useful and facilitative. Facilitative is the word that is important, because if a client is so overwhelmed by,
 say, fear, that they can’t take on board anything else because they’re in such a state 
of stress, then wouldn’t something chemical just help to take that person back from 
the edge and allow them to sleep? To interrupt that vicious circle and leave an
 opening for movement in the direction of recovery.

Non-Hierarchical Approach

The people that I know in the medical profession who have that openness are
 people who have been in therapy groups themselves. It would seem to indicate that
 in the medical profession generally there is a nervousness about acknowledging
 themselves as being clients or patients, a kind of hierarchy. And I know that
 psychotherapists are not immune to that either – “I have done so many years of
 psychotherapy so I’m a better human being than the client coming to me.” But at 
least the vast majority of therapies require the practitioner to have been a client for
 a long time – not just a few sessions.

Long Term Therapy?

One of the things that I wonder about at this stage too is the continuance of the
 necessity for really long-term work. By really long-term I mean anything over 
three or four years. Now, in nearly seventeen years of full-time practice, I can’t
 deny that there have been a number of people that I’ve worked with who evidently 
did need really long-term work, not only for recovery but for growth and 
development (see Maslow). But I think maybe, here in Ireland, with the greater 
willingness to acknowledge, to name, to recognize abuse and stress and trauma and 
dysfunction and so on, that may enable more of us to start in therapy at a point 
further along from where we used to start. People are clearer about the harm that 
they have experienced. It’s not explained away, and they don’t have to go through
 the whole business of realizing it in therapy, so maybe that is one thing that will 
make more of a difference to the practice of psychotherapy as time goes on.

The Question of Strict Confidentiality

Maybe this familiarity in the general public with reasons for going into therapy, 
and maybe a slowly growing collaboration among professionals on behalf of 
individual people or groups, will make a welcome difference the very strict, tight 
practice of confidentiality. This may be a bit dangerous to say, but anyway it’s
 certainly a question and a possibility that I’m noticing. I know it would take a lot
 of thought and respect to change, carefully, in a way that is really focused on the 
benefit of the person who is the client, and not just to let it become a matter of
 interesting conversation between people, even professionals – it’s too easy for that 
to become disrespectful gossip, as it does in the chat shows. I used to think of 
Oprah Winfrey as providing an amazing service in the earlier years of her 
programme, but I feel a lot less happy about more recent ones and about other
 people who are copying what she has done. At times it seems to me that they have
 verged on being abusive, perhaps even more of the people who are not in the 
shows. Some of those programmes are pretty hair-raising! Maybe lots of people
 watch them and know what they are letting themselves in for if they go – but then, 
what about the people who haven’t chosen to go and are implicated by the 
revelations that are made? What choice have they had?

Loss of Empathy

One of the things that horrifies me about television and film and maybe even the
 written medium, is what we are calling entertainment: the horror – the exposure -
 the violence – that somehow has become entertainment. I’m concerned about what
 that is subtly (or not so subtly) doing to our sensitivity and relatedness. It’s like we 
are entertained by people’s suffering, entertained by people’s violence, entertained 
by the thrill of computer games that are abusive and violent. That really bothers
 me. If I were paranoid, I might be thinking, are there groups of people around the 
world doing this consciously and deliberately? It feels like an undermining of
 humanness, an undermining of our capacity to feel what it might be like in the
 other person’s shoes, that kind of empathy. That troubles me.

On the one hand, are we going to have to deal with people who are traumatized by 
what is done to them via the media? But are we also at some point going to have to deal with massive desensitization and massive dissociation, which may be the
 only way people can protect themselves from being overwhelmed by traumatizing
 sights and experiences? Or even with media-induced addiction to the adrenaline 
rush of horrifying things? A detachment from sensory experience and your own body?

It seems paradoxical that as psychotherapists we would be called on to help people 
to resensitize, to feel a lot – not to retraumatize themselves, but to expand their
 capacity to experience life with everything that’s part of it, instead of becoming 
’emotional zombies’. My immediate thought about this is that such a desensitized
 person might be wakened up to their need for therapy by the demands of a 
challenging relationship.


I wonder, is post-trauma work in a very specific way going to become much more 
needed? In this funny world we have, there are tremendous advances in terms of 
the expansion of the means by which we experience ourselves to be in relationship
 with each other and also with animals and trees – the whole ecology consciousness 
and sensitivity that’s growing – and on the other hand, there is the amazing 
insensitivity to fellow humans. It doesn’t seem to matter what country, whether
 north, south, east or west, there is slaughter – whether it’s someone taking a gun
 into an American school or militia who round up women and children and 
slaughter them, and do their best to wipe out the other. Need this be? The whole 
dualism that we live in and struggle with! Wilber comes to mind, and his
 description of movement towards an increasing identification of self, an expanding 
identification of self, not just of the part presented to the world. His map is based 
on the supposition that ‘what I present to the world is what I believe the world will 
approve of , and on the whole that’s been ‘goodness’. But it seems to me that there 
are places in the world where what a person can experience as being approved of 
is abusiveness and destructiveness and violence. But anyway, whatever the 
Persona, there is the incorporation of the Shadow, and the need to acknowledge that 
too as part of our energy.


Should we be trying to create a Utopia? No, I guess I’m just shaking my head in
 somewhat bewildered contemplation of the contradictions of our world, the 
dualism that we stagger from one side of to the other, for so much of the time.
 Quite an experiment this business of energy becoming material, you know!
 Actually that’s one of the things that has become even more evident to me, as a
 practitioner of psychotherapy – the need in myself as a practitioner for a very, 
very broad view of life, and the discovery of a position in myself that is not
 dissociated, but that can look at the world and life with a kind of equanimity and
 maintain the observer’s place, therefore to some degree separate, but laced with 
compassion. Maybe it is to the degree that we can know such a place in ourselves 
that we can be with the dreadful things that we hear and the appalling effects that 
we see in our clients. And let me not forget about rejoicing – appreciating and
 rejoicing in the amazing capacity that embodied life has – resilience and recovery 
and expansion and joy and ecstasy and, yes. love.

Una Maguire is a psychotherapist and founder-Director at the Institute of
 Creative Counselling & Psychotherapy in Dun Laoghaire.


Maslow, Abraham: Towards a Psychology of Being, 1968

Wilber, Ken: No Boundary 1979.