Regents College London 11 – 14 July 1991

Ger Murphy

It was an encouraging and exciting sight to see about 300 psychotherapists from 
America (North and South), Europe, Australia and Africa spend four days together in a 
beautiful old London college discussing the theoretical, clinical and research issues 
involved in psychotherapy integration. All the main schools of psychotherapy were there: 
behavioural, analytic, humanistic, cognitive ansd systemic. They were there to see what
 could and could not be integrated. The Americans seemed to outnumber the rest which
 is hardly surprising since SEPI has been mainly an American based organisation until 
the past 2 years. Also with 50% of American psychotherapists now defining themselves
 as eclectic or integrative, it is obvious that a lot of the energy would be coming from 
there. (Norcross et all 1989)

However, the fact that the conference was on integration not eclecticism was what 
gave rise to most interest. (Eclecticism is defined as the technical and theoretical com
bination of methods, while integration is more about the search for a conceptual and
 clinical synthesis of diverse theoretical systems. (Norcross).

The conference took the shape of lectures, workshops and, what for me was the most
 interesting, practical demonstrations with presenters offering video tapes of their work 
and exploring their integration of various frameworks through this. For example, we had
 three practical presentations of working with clients with a similar presenting issue. In 
this case they dealt with a client presenting with a harsh internal critic or excessive self-
criticism. It was in these discussions that the many possibilities of integration and its 
many difficulties really emerged. The value of using a theoretical and practice frame-
work which drew on the treasures of different schools was explored in depth here.
 Various meta-models for understanding integration were offered and outlined. An example of this was the schema offered by Dr Richard Erskine of the New York School of
 Integrative Psychotherapy where he explored the different questions focused on by the 
main schools of psychotherapy and how all of these questions needed to be asked.

Erskine posited that in exploring how to facilitate change it is important to look at
 all four aspects of the person’s functioning. Through this one would explore a person’s 
behaviour and what they need to change in it in terms of their dynamic history and structures of meaning, while allowing them to change by the release of feelings through an
 exploration of how their holding patterns are also structured in their bodies.

Another meta-model offered was one by Dr Petrushka Clarkson of Metanoia,
 London in her outline of 5 types of therapeutic relationship which a client may need in
 the course of therapy.

COGNITIVE ANALYTIC – “why” questions
 (Freud, Ellis)

AFFECTIVE -
 “how” questions 
(Rogerian,
Gestalt)

BEHAVIOURAL. – “What questions” (Skynner)

PHYSIOLOGICAL – “where” questions
 (Reicit, Lowen)

This allows one to draw techniques and ways of relating from the
 various schools of psychotherapy at various times. The relationships she defines as:


1) A working alliance


2) A transference relationship


3) A developmentally needed relationship


4) An I-thou or person to person relationship


5) A transpersonal relationship

Also of great interest was Dr Tony Ryle’s presentation of short-term cognitive-ana
lytic therapy lasting a maximum of 18 sessions and designed by him over the past 10
 years for use in a health service setting. Furthermore we were treated to presentations
 on integrating cognitive therapy and Gestalt therapy, Rogerian and Kohutian Analytic 
Therapy. For good measure there were a number of presentations on Integrative
 Psychotherapy training from trainees in Belgium, US, and England, as well as research
 papers on integration practice.

I left the conference tired but excited that this ground-breaking work is well in 
progress in psychotherapy. Perhaps we will catch up with the physicists some day as they
 allow light to be a wave and a particle, by allowing our tightened boundaries around
 schools of psychotherapy to expand. This is not so that we can merge into a structure
less morass but so that we can be responsive to the real needs of our clients and no longer 
do as Abraham Maslow said: “When you hold a hammer you run the risk of treating everything as a nail” and thereby move away from treating all issues and persons only from our own preferred technique base.

The lingering question that I am left with is whether integration is really something 
to search for through the pursuit of ways to bring together a synthesis of theory and
 thereby end up with a finished product? Or is integration rather an ongoing process only 
given life by each meeting of the client and therapist where each is searching for inte
gration. If we see psychotherapy as an activity engaged in when our innate urge toward 
personal integration is blocked or frozen usually out of a fear of disintegration, then we 
must focus on how each client and therapist copes with disintegration in their meeting.
 By this I mean the disintegration of character structure, of habit, routine and boundary, 
and their reformation. We then have to focus also on how both parties can cope with
 the ambivalence in the relationship between contact and distance, certainty and doubt 
process and content and being and doing. Perhaps only by facing such ambivalence individually can we cope with the fears that giving up the beliefs that we hold on the truth 
brings up. For example, I would postulate that each psychotherapist’s choice of theo
retical perspective whether behavioural, humanistic, analytic etc., is guided as much by
 our own character patterns, defence structure and search for personal wholeness as it is 
by purely intellectual considerations. From this I am left wandering whether the con
ference would also have benefited from some form of personal therapeutic group being on offer in order to balance the bias towards the cognitive which was evident.

I will end with a quote from the ending symposium of the conference:

“I admire those who search for the truth, I avoid those who find it.”

There was little to avoid here and much to admire.

The next SEPI International Conference is in San Diego, California in April 1992 
and the British branch will hold a conference in July 1992. Further information can be
 had from the Journal of Psychotherapy Integration, Dept of Psychology, University of 
Arizona, Tuscon AZ 85721.

References:

Clarkson, Petrushka, “A Multiplicity of Psychotherapeutic Relationships, British Journal of
 Psychotherapy, Vol 7 No.2 Winter 1990

Norcross & Dryden (Eds), “Eclecticism and Integration in Counselling and Psychotherapy”, Gale
 Centre Publications 1990

Ryle, Anthony, “Cognitive Analytic Therapy, John Wiley & Sons 1990.