Where now? The Challenges Ahead – One Psychotherapist’s
 Personal Story and Reflections


Sally Phalan


As this is the last issue of Inside Out, I would like to begin by thanking the journal
 for how it has connected me with the broader world of psychotherapy in Ireland. It 
has been invaluable. I shall really miss it and the opportunity in each issue to
 encounter new ideas, share someone else’s adventures with clients, hear of new
 courses or workshops etc.

This final issue has a challenging theme: – the Future of Psychotherapy. Perhaps
 some of your readers, like myself, have been evolving new ideas for the way ahead.
 Now would seem a unique opportunity to speak out and share them. Maybe by 
doing so, new connections could be made, and new structures come into being. It
 certainly seems worth a try.

I will begin my own effort at reaching out with some personal information, and 
then move on to discuss some ideas I have been developing regarding future
 directions.

Personal Story

I think I always wanted to be a psychotherapist, but it took me a long time to find 
out that that was what I wanted. And then when I did realise it, I still had a long
 way to go before I could train. It was a journey that led me, initially, through a
 Montessori training, followed by some years of teaching in a special school, and 
then on to Chicago, where I began by working as a ‘Counselor’ with emotionally
 disturbed children in a residential treatment centre, but ended up teaching them. I
 actually had to come back to Ireland to find the training I was searching for!

I was eventually able to obtain a professional qualification including a Master’s 
degree in Child & Adolescent Psychoanalytic Psychotherapy. I began working with 
clients, over eight years ago, while still a student, and have continued ever since.
 At one time I did a lot of my work in schools, but now I work in a room I rent in 
a General Practice.

So in one way I have arrived, and am very happy with what I am doing, but in
 another way the journey continues – does it ever end? As regards clients, while the 
bulk of my work has been with young people and their parents, I have responded
 to the requests of some adults who wanted me to work with them therapeutically, 
and have thus developed another aspect of my practice. Recently I have become 
particularly interested in working with couples in conflict (separating or separated)
 to help them move on to being responsible joint parents, either healing their 
relationship or at least minimising its negative effects on their children. Very
 challenging work at times!

As regards my theories and techniques, it has often been the attempt to meet the
 needs of particular clients that has sent me off in new directions. I use, for example,
 and as appropriate, Psychoanalytic understanding, Systemic thinking, Inner Child
work, Solution Focused questioning, and techniques and attitudes from ‘Focusing’ 
(a Rogerian body-based approach). This may sound a lot, but developing these 
approaches has been a gradual journey with an organic movement to it, i.e. one
 thing leading naturally to the next. I am currently looking forward to embarking on 
a Jungian Sandplay Therapy training.

Over the years I have also attempted to build working relationships with other
 professionals with varying success. I have had the experience of referring children 
on and then simply losing the case, but I have also had positive experiences and
 received great benefit from building professional relationships with colleagues -
 for example, a Family Therapy associate, with whom I have been able to discuss
 and share some cases, and a Montessori friend, who referred some children to me
 and whom I worked closely with for a time. In both these situations there was a 
pooling of resources in a very fruitful way in order to help our clients.

Looking Ahead

So what might be the next step? In the last couple of years I have considered 
sharing in a group practice. I would like to develop, along with others who share a 
similar philosophy, an excellent professional psychotherapy service. I am
 convinced that no one therapist can meet the needs of all the clients that present 
themselves. One great strength I discovered in Solution Focused Therapy, is the 
benefit of working as part of a team. The solitary therapist, even with supervision,
 may be tempted to feel inadequate, or to see clients as ‘difficult’ or ‘resistant’ when 
things are not working out. But people are different, they can sometimes benefit
 from a change of approach, or even the different personality of another therapist.
 A group practice could allow for joint discussion of ‘difficult’ cases, and a fruitful 
system of cross-referrals. Where this kind of structure is not in place, then referring 
on can be a tricky business in the course of which clients can get lost. It would
 seem that a practice made up of a group of closely linked psychotherapists, from 
different disciplines and with a wide variety of different skills to offer, could
 provide a more comprehensive service than is currently available.

On the other hand, the setting up of a group practice is a major commitment
 involving buying or renting a premises. It might be more sensible to consider a 
modest beginning such as the formation of some new structure that could bring
 together psychotherapists interested in moving in a more collaborative direction.

I am also aware that psychotherapy is striving to become recognised as a 
profession in its own right, which is necessary. Yet it is probably inevitable that in
 doing so it will become more institutionalised, and that there could be loss as well
 as gain. It is already the situation that the Irish Council for Psychotherapy is 
divided into different sections, and that we tend to develop ourselves professionally within our own sections. Some of the sections are more varied and eclectic than
 others, of course, but could it happen that in seeking to define our individual 
approaches we could become more rigid and exclusive?

This is a pattern that seems to crop up in all areas of human development. I think
 of the early days of Freud and his disciples, also what has happened in the world 
of Montessori – a stage of discovery is followed by a stage of consolidation. Then 
new discoveries begin to be made by others within the group who may start to 
question even some of its basic tenets. Tensions arise. Those who are happy with 
the status quo, or who fear the loss of what is truly valuable in their tradition, often
 move to exclude the innovators, who may be seen as rebels and become more and
 more reactionary. Frequently there is a split, and another generation may pass
 before the new knowledge is properly assessed and assimilated. In the meantime, 
due to the painful divisions, a positive creative tension and potential rich dialogue 
is lost.

But does it have to be like this? One thing Focusing has taught me is to make space
 inside for the simultaneous presence of different, and sometimes conflicting
 feelings. The developer of Focusing, Eugene Gendlin, uses the analogy of two
 belligerent teenagers – you can love them both, but you need to keep them apart so
 that they can’t fight.

What I am calling for now is the formation of a new structure or organisation that 
might be called ‘Open Forum for Psychotherapists’ (or Psychotherapists and
 Counsellors). It would be designed to serve – as the name suggests – practising
 therapists of all training backgrounds, but the meetings could be open to all those
 interested in attending and contributing ideas. Such a forum could provide a space
 for those innovators who currently may be walking a lonely path, but who are also
 at the creative growing edge of our profession. It would equally welcome those 
who are satisfied with what they have, but open to being refreshed by new ideas.
 Ideally many of those who came would also continue to remain closely linked with
 their parent groups, so that the flow of ideas could move in both directions. Such 
an open forum should not become institutionalised into a rival group, or it would 
risk falling into the same old pattern as described above.

Both Focusing and Solution Focused Psychotherapy claim to have developed their 
approaches as a result of research into what works in psychotherapy. They attract 
practitioners of different orientations and point to the essential elements that we
 have in common. Is it not true that as we mature we tend naturally to draw closer
 to each other, and we have more and more to give to each other? Yet, at the same 
time, as we become more established there is a countertendency to draw apart as
 we define ourselves more. To maintain a healthy balance in the profession, should
 we not develop structures to express both of these tendencies?

Maybe from such a group a new journal could emerge, and maybe group practices
 would develop out of this naturally. And even for those of us who might baulk at 
major changes in our individual practices, it might make possible special links for 
working more closely together to provide a more comprehensive service for
 clients.

Anyone out there interested?

[Sally Phalan is a psychotherapist working in private practice in south County 
Dublin. She can be reached by e-mail: sally.phalan@oceanfree.net]