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.
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.
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: firstname.lastname@example.org]