Malachy Kinnerney talked to Mary Montaut
I was very pessimistic up to a few years ago. My biggest fear ten years ago was that therapy would become monolithic, and I’m glad that hasn’t happened. I know fragmentation can be very damaging, but I think in Ireland the fragmentation is working to good effect, in that it has prevented a monolithic take-over of therapy. I was really worried about that and I felt that there was either a conscious or a semi- unconscious move on the part of the religious establishment to try and get their hands on this movement. Now I think that battle has been won, and that they’ll never be able to do it now. But having said that, one concern that I do have is that quite a lot of what I call ‘ex-religious’ are filtering into the profession and trying to use therapy as a route towards evangelisation, conversion and a wishy-washy spirituality. One of the things that I would like to see in the future is a sound psychology, a sound therapy and a sound spirituality, but not a watered-down spirituality or a watered-down therapy that does not do justice to clients. My fear would be that we would get a lot of the distortion that we’ve seen in religious life filtering through a wishy-washy spirituality. This isn’t really just a battle of secularity versus religion, it is really about a wholesome attitude towards human beings, that has won out and that institutionalised religion cannot now take over.
Men and Therapy
I’m positive about the outlook because I feel that counselling and therapy together have helped the Irish nation to grow up and especially helped women. By and large. I am more pessimistic about men in relation to counselling and therapy, however. I do feel that, for whatever reason, it has not impacted yet on the male section of Irish society. I feel a bit disappointed about that but I’ve seen little or no change in the ten or fifteen years I’ve been involved in the world of therapy. But then of course, I do believe the future is by and large with women anyway. I think they will change the men ultimately, both in politics and social life, and in emotional life. It’s around the area of emotions that they will have the largest impact, whether it’s in individual relationships or in institutions.
Need for an Ombudsperson
One of the things I would like to see is the provision of counselling and therapy in the Health Service. I feel that there should be access within each Health Board to a body of counsellors, and that counselling (and I don’t mean Guidance Counselling) should be available at primary, secondary and third level schools and colleges and in adult education institutes as well. Of course, that means that there should be a move to also provide therapy through the VHI. In relation to that, I feel therapy and counselling are now affecting so many people’s lives – we’re talking about child abuse, divorce, abortion, adoption, etc. – and there is so much money involved in it. that if it were in any other area, somebody would have been appointed by now to oversee it. And while I wouldn’t like it to be over- institutionalised, I feel that there are now so many people’s lives at stake here. I would call for an Ombudsperson to oversee the various bodies at voluntary, community and professional level. There should be access to an Ombudsperson where clients or organisations feel that they have been abused, or where organisations set themselves up without clear and adequate criteria.
Access to Counselling
An example would be Guidance Counsellors in schools, who really do more guidance than counselling and actually promote people towards third level and job appointments. Now, whether schools have a high academic achievement or not, counsellors are needed in the schools. There is a lot of emotional disadvantage, a lot of disturbance, a lot of break-down in the families and communities, and so on. So I would be asking that counselling should be established on a separate track from career guidance in education, for the emotional, social and psychological development of pupils, students and trainees. Similarly in the Health Service, where people are not in the VHI, local community services would be able to provide some counselling and therapy on the medical card system, just as with any other illness. I suppose the fact that in Ireland we don’t have therapy or counselling on the VHI does suggest a block in the psyche somewhere, that it’s OK to break your arm on the VHI, but it’s not OK to have a nervous breakdown, emotional or psychological upset. Interestingly enough, you may get support if you’re an alcoholic or a drug-addict, but you will not get support if you have been severely abused, rape victims are not properly provided with support, nor are battered people – a whole range of people are excluded from psychological healing. It’s as though we have this split still permeating our ideology and social approach, that the physical can be looked after, but we don’t want to get involved in the emotional and psychological well-being of people.
Luckily we haven’t had any major disasters here as they have in Britain, but I’ve been reading a lot about the team supports established there, and I dread to think what would happen here if we had a major disaster. When we have had examples of abuse in institutions, there has been no team to deal with this. I am calling for a national task force that could go to a disaster, like the fire at the Stardust in the early eighties, and certainly within each region there should be a pool of counsellors who could go at a moment’s notice, like the fire brigade, if the community says it cannot cope, as in Omagh for example. The team would be there, so that support can be provided. I think that would be something quite useful for the future in the various regions of Ireland.
Need for More Integrative Approach
At the moment, there is an absolute obsession with the accreditation/professionalisation of counselling and I think that people are either in denial or dismissive or indeed antagonistic towards the massive amount of counselling that goes on in the voluntary sector, in the community and in the established professions like teaching, nursing and so on. It’s as though these voluntary people are being treated almost as subservient to the big, accredited individuals, who have paid enormous sums of money for their qualifications and who are addressing themselves to a pretty narrow band of society – the YAVIS (the Young, Articulate, Verbal, Intelligent and Sophisticated). That’s by and large the clientele that they are addressing. Even though the professional counselling organisations are in powerful, self-regulating positions and have tremendous independence, I am very concerned that they are not promoting counselling at all levels of society and at all stages, whether voluntary, community, semi- professional, clinical, and so on. I feel very strongly that the Samaritans are dismissed, the Rape Crisis Centres are dismissed, and the Child-Lines. I think the backbone of counselling ultimately is very much with the voluntary community sector. Very often front line people who are not ostensibly counsellors, are in a tremendous position to help people in all sorts of situations through support groups and so forth. I would like to see a more cohesive and integrative approach – we have it within therapy, why not on a social, educational and geographical level?
When there is a major issue like child abuse or divorce or abortion, these professional organisations lie low. They will never stand up and be counted even though they have the resources and the woman power and man power, they have the education, qualifications. I feel that there is a discrepancy of some kind. They say very little in the national press – for instance, about battered people, or the poor service offered to rape victims who have to wait endlessly on waiting lists for counselling, support and therapy. In a way the Yuppie mentality seems to have filtered through to the counselling and therapeutic community. They do not want to be challenged, and would probably resist very strongly the appointment of an Ombudsperson. Individualism rules within and outside of the therapy room. I wonder whether it is because most accredited practitioners are generally working in isolation, that they don’t seem to take part in the political life of society. Needless to say, you can’t bring the political into the counselling room, but there is no justification for not bringing it up outside of the room. It’s not inappropriate for groups of therapists or counsellors to campaign on social, political, moral and economic issues affecting them and their clients.
My other area of concern would be the psychiatric profession. Again the counsellors and therapists have not campaigned with outrage at the way that patients are still being ‘treated’. To give you an example, a young woman was admitted to a psychiatric insitution a few weeks ago. and she was put in a male ward with perhaps ten or twelve males in various states of psychiatric disorder and alcoholism. Needless to say, she was quite disturbed anyway, but when she was put in this ward, she ‘freaked out’. She was taken by four men, pinned on the bed and injected. She subsequently ran away from that institution. This is 1999. but it’s like a spectre out of One Flew Over the Cuckoo’s Nest! So it would seem that, even though we’ve had therapy courses established in places like St Vincent’s and available to a lot of medical personnel, they have had little or no impact on the medicalisation and chemicalisation of treatment. In a way, again, the therapy organisations have been very reticent in challenging this publicly – politically, socially, in terms of lobbying and so on. It doesn’t cost a lot to put letters in the paper, it doesn’t always have to be Ivor Browne or Michael Corry! A group of well-established counsellors could make themselves heard, if they were to say that they are very concerned at the way doctors and psychiatrists in general are still looking to ‘a pill for every ill’, rather than a skill. I am very worried about that. They seem to work on the principle or paradigm that it’s either pills or counselling, them or us – whereas any enlightened therapist now would take it for granted that in some cases people do need medication, but only as an aid to help them talk out and tell their story and reach the core. Likewise an enlightened person nowadays in the medical-psychiatric establishment ought to realise that once they have taken this person to a stage of equilibrium, they should send them to where they can tell their story. Most people who are medicalised are actually put on ‘hold’, it’s like a tape recorder where the ‘pause’ button is pressed but never released to allow the person to rewind, start again and move forward.
Removal of Stigma
I am very pleased about the currency and popularity of counselling. I remember when I started training, many people did not even know what the word meant! The truth of counselling as a talking, healing procedure has really triumphed – even though the psychiatrists are carrying on in their own world! The battle has been won in Ireland. If we have anything to thank the religious for, it might be the confessional, because the priests placed themselves as ‘doctors of the soul’, whereas the others called themselves ‘doctors of the body’. In a weird way, the doctors of the soul and doctors of the body have both lost their credibility and by and large, the general mainstream of society now does not see a person going for counselling as having a stigma of any kind. One of the tutors here at ACCEPT, who also works at a university, told me that the people who come in for counselling there now feel that it is like asking for a grant or for their rights in housing and accommodation – it’s a normal thing, they can just come in to talk – whereas the older generation perhaps still feels the stigma and fear around therapy. It makes me optimistic to see that young people are in touch with their feelings and have been brought up to talk from a different centre than I was allowed to do. They have a self-confidence earlier in their lives, that many of us had to fight to get and so there is still a defensiveness around even that kind of confidence.
The Irish Approach
I mentioned earlier that I am worried about the way therapy does not seem to have impacted on men in our society, and very few politicians – who are mostly men - seem able to address emotional and psychological issues. But that’s where the future lies – men are not yet able to speak out. Anonymity is difficult in Ireland, and this may deprive a lot of people from having access to counselling. But there is a certain maturity coming about in Irish society, and within the field of counselling and therapy the Irish approach is not only mature but it is very different. I’m delighted to see that, just as we avoided becoming a British clone or slavish follower of the BAC model, neither did we adopt the highly legalistic and technological American model, but somehow or another we have achieved an easier approach that spans American, British and European trends. Most of the therapists in Ireland now, I feel, don’t have the fanatical orthodoxy that we see in other countries. There is a fluidity about therapy in Ireland, and somehow our genuine tradition of story-telling has come through – therapy is seen as story-telling which can tune into this ancient tradition. I think that’s the special Irish contribution to counselling and therapy centres around the concept of ‘story’, told, heard, understood, believed and responded to with warmth, empathy, humour and compassion.
[Malachy Kinnerney is Director of ACCEPT Counselling Association of Ireland.]