Letter to the Editors

by Matthew Henson

Can we have a conversation please?

I often don’t know whether to laugh or cry at the speed with which complex socio-political issues get polarised and reduced into their lowest common denominators, and the rapidity in which dialogue and debate gets replaced with vitriol and rhetoric. To our West we have controversies such as the US president’s foreign policy; to the East we have Brexit; and at home in Ireland we have, amongst other divisive issues, the 8th amendment. In these respective chasms, many – on both ‘sides’ – resort to soundbites and slogans, with little by way of listening on either part. In our adversarial political and legal systems, there is often little room for complexity, paradox and doubt. This is perpetuated in the media and mirrored in homes and communities. I am ‘right’ and you are ‘wrong’. It’s that simple.

Thank goodness then, that we have the ‘talking therapies’, in particular psychotherapy, where dialogue is supported perhaps more than in any other professional process. When socio-political issues enter our consulting rooms, we quickly understand that one ‘side’ is never all ‘good’, just as the other ‘side’ is never all ‘bad’. We understand that processes which integrate are generally much more helpful than processes which divide and split. We understand complexity and we can sit with tension. We understand that a well-thought-out preference for devolved government is not necessarily also a preference for racial hatred, just as a preference for Europe-wide legislation is not necessarily also a preference for unrestricted globalisation. We understand that arguments in favour of reforming pregnancy law are not necessarily anti-life or a failure to ‘love both’, just as arguments to keep the 8th are not necessarily misogynist.

Thank goodness then for the talking therapies, well used to holding complexity across all domains; intellectual, physical, emotional and spiritual. We understand ambiguity and ambivalence. We support the changing of minds when new information comes to light or when a change of heart occurs for no easily identifiable reason. In our consulting rooms, we empower the (sometimes very quiet) voices of our clients and delight when their voices strengthen to challenge our own. We tolerate and withstand levels of uncertainty, anxiety and grief that would debilitate other professional processes. In the nebulousness of a reality where there are no universal ‘correct answers’, we understand that the decision-making process is more important than the decision itself. We hold all of this, arguably, better than (or at least as good as) any other profession and we achieve this primarily through dialogue. We are the ones willing and able to listen and respond, when nobody else can or will.

Thank goodness then for us talking therapists, well able to dialogue and converse about complex and emotionally evocative socio-political issues. Except, it seems, when the socio- political issue in question is our own professional future. Then the ability to dialogue appears to elude us. I am staggered by the silence that surrounds state regulation of psychotherapy and counselling. It has proved a very difficult subject to debate.

I have no grievance per se with those who favour state regulation in its current form. I hold different views, but that’s fine; differences of opinion are healthy and can be a great spark for creativity. My grievance is with the complete lack of appetite for genuine dialogue and the ways in which attempts at dialogue have been stifled. There have been consultation exercises for sure, but that is not the same as open discussion and debate.

Of the many dialogue-stifling statements I have experienced over the past few years, the one that starts and ends: “It’s about public protection!”, is the most unhelpful. That statement simplifies and polarises the issue of regulation quicker than social media simplifies and polarises Trump’s stance on immigration. Even without the exasperated and/or condescending tones of voice that often accompany it, the statement is offensive. Of course it is about public protection. Public protection is also the principal concern of those who question the wisdom of state regulation in its current form. Public protection is not the sole province of those in favour and should not be claimed as such.

Preference for a system of governance that supports pluralism, diversity and choice is not a vote against public protection. Preference for a system of governance that is not implicitly biased towards a medical model conceptualisation of human distress, is not a vote to increase risk of harm. Preference for inclusivity rather than exclusivity, is not an argument in favour of exploitation. Expression of concern about the proposed future training standards, is not an argument in favour of abuse. Of course it is about public protection, but protection of whom, from what, by whom and, importantly, at what risk and at what cost? This is a complex terrain. We oversimplify and polarise it at our peril.

Some of the responsibility for the lack of dialogue rests with those who, for whatever reasons, have not joined the debate at all. This letter is first and foremost a plea to those psychotherapists (and counsellors) who have not yet registered their voices. Legislation which designates ‘psychotherapy’ and ‘counselling’ as protected titles has already passed. We must ensure now that the costs of this legislation do not outweigh the benefits. The future of psychotherapy is still in our hands, but not for much longer. There is no hiding from this reality and time is running out. Regardless of what might or might not have gone before, what is needed at this juncture is a proper dialogue, and that dialogue needs to happen now. Can we have the conversation please? Can we do for ourselves what we do so well for others, make space for all voices to be heard? Or have we already self-regulated the talking therapies into silence?

Yours faithfully,

Matthew Henson, Psychotherapist
28 April 2018