Quo Vadis

by Paddy Logan

I began secondary school in 1963. It was a school run by Christian Brothers where everything was taught through Irish. In secondary they taught me Latin through Irish – a combination rare in its uselessness for meeting life in the nineteen sixties. Yet at the time this was seen as best practice in regards to the education of young men. If you and I were alive in earlier times we would accept that the earth is flat or that the earth is at the centre of everything or perhaps new knowledge has just confirmed it’s the sun that’s at the centre. Perceived reality seems transient as are our maps for understanding it.

Never the less best practice would suggest not wandering off the edge of the known map. This is logical and reasonable. We therapists try to follow an urge for maintaining professional reliability, informed practice and ethical standards. We put in place corrals that boundary what is seen as trustworthy. The containment this provides brings insurance to some degree that we are acting responsibly with integrity and fairness. It’s a sign of maturity that we do this.

There are deep and significant changes gestating within our profession in Ireland. We are seeking out the boundaries of what can be recognised as best practice across many aspects of psychotherapy. IAHIP and other associations are working to consolidate these changes into a coherent position. This is also logical and reasonable. It is ironic, is it not, that the people whose theories we learn and teach and model our therapeutic relationships on, in humanistic terms people like Rogers, Perls, and  including many others from various psychotherapy approaches, are all examples of individuals going beyond or even against what would have been seen as best practice in their times. If these people had followed the contemporary perspectives of best practice we probably would not be working the way we do today. I wonder if a logical and reasonable position can be found in relation to that reality.

Several years ago someone told me “all horizons are limitations”, an interesting position to hold and experience – one which takes account of the very forces that our Code of Ethics (IAHIP) gives emphasis to:

2.1 Humanistic and Integrative Psychotherapy emphasises that persons are self-regulating, self-actualising and self-transcendent beings, responsible for themselves; and whilst recognising the tragic dimensions of human existence, it emphasises the ability of persons to go beyond themselves and realise their nature more fully.

The therapists we study, whose insights we seek to understand more effectively, had each to cross beyond a horizon in order to discover what we now hold as commonly accepted criteria regarding the practice of psychotherapy. There are always forces which will cleave exclusively to uniformity and perceive that as a safe haven. Self-actualising is not a clean, neat and compliant activity. Its emergence will not necessarily be tidied up by rules, regulations, criteria or knowledge.

For therapists this can create an internal unsteadiness in the face of external perceptions. We need to be familiar with, confident of and proficient in the ownership of our theories and approaches, especially when we enter a negotiation with outside interests concerning the best application of these.

Other agencies with very different context’s cannot be expected to share the understanding of the principles of humanistic and integrative psychotherapy that we apply to ourselves. Nor can they be expected to automatically align with our code of Ethics. It is unlikely therefore that they will experience an enduring commitment to our theoretical position and may not be free in the long term to uphold the tenets that we take as central in providing psychotherapy. It is essential that we do not set in place changes and criteria that are based on misunderstanding or mistrust by others or ourselves of what we do. To do so might, over time, jeopardise the essential connectedness we need to maintain to the core principles of what we do.

Perhaps we need to hold our nerve in these times and recognise that for any of the emerging changes and criteria to be ethical and effective they must proceed from a direct link to what we as Humanistic psychotherapists are engaged in achieving. The Code of Ethics helps us in describing the focus of what we do:

2.2 Its focus, then, is on individuals as organisms seeking to attain integration in the wholeness of body, feelings, intellect, psyche and spirit, and in relation to other people.

2.3 Since Humanistic and Integrative Psychotherapy is based on a phenomenological view of reality its emphasis is on experience and the nature of the therapeutic relationship is seen as meaningful contact between persons.

So any changes, affiliations or criteria which are introduced into our work must, I believe, clearly demonstrate an enhancement to the application of this focus and how it is to be understood, taught and applied.

2.4 Humanistic and Integrative Psychotherapy acknowledges the validity of a variety of approaches to the individual. While accepting the contribution of many approaches, it is concerned with discovering and working with the essential elements of the functioning individual as these are understood and made sense of in a humanistic perspective.

The most sophisticated possibility that therapists can mirror is the potential to become. The essence of what we are engaged with is a trust in individuation, and this remains always off the map, an unknown potential. It is clear that we place emphasis on three of the core conditions described by Rogers as central to what we do, empathy, congruence and unconditional positive regard. We would wisely remember these are fundamentally energetic and physical phenomena and not psychological constructs. Empathy is a phenomenon that occurs when we are accurately attuned to someone. It remains a mysterious event, which can only be properly appraised experientially, beyond academic or intellectually digested insights. It is not the result of an action but a response to systems energetically aligning between both people. We believe this is one of the phenomena in our approach that supports the possibility for individuation.

An approach such as ours to the application of psychotherapy does not fit comfortably into the culture we inhabit. It does not concede to limitations on growth by money or time or location or ideas of perceived practicality. We are not in this work to fix things or solve things after a deadline but to form truthful relationship. The capacity for that and the possibilities within it draw on the therapist’s ability to be experientially present. That is not a dynamic which facilitates a prioritising of economics or budgetary concerns.

Individuation is not a phenomenon that blossoms well within systems that place economic efficiency at their core. The superego in such systems does not hold a deep capacity for valuing experiential authenticity. Individuation does not thrive well either in the anxiety that often underscores the aspiration for control in such systems. Still we seem in a generous mood, working very hard to be legitimised and included in the ambit of political authority. Why is that I wonder? What is so obviously good for the application of humanistic and integrative psychotherapy in these systems that we now strive to be accepted by them? What if we don’t enmesh smoothly or agreeably with them? Might we be outlawed then, positioned outside the collective corral?  Do we truly aspire to being partially grafted onto a system such as the HSE which is so obviously flawed and contra-indicated with regards to providing developmental psychotherapy on a one-to-one basis? Developmental psychotherapy takes time. The HSE consistently cannot afford to pay for such time. Evolution of consciousness is not a cost effective force.

There is now also a developing European dimension to our work. We are becoming part of a larger idea of a system about which individually we probably will know little. This system like every other of its form, will be populated by individuals from various persuasions, who for a short while hold sway in temporary positions on committees, over the future course of this profession. If we are to trust individuation, as we are bound to, we will create scope for an Irish dimension to any criteria laid down for the management and application of Humanistic & Integrative theory and practice. It will be based on what our expressed experience indicates as best practice and this might perhaps one day include client’s experiences. It’s primarily for their benefit after all, isn’t it? It would not be respectful to ourselves to fully surrender the responsibility for making changes regarding best practice to agencies or practitioners outside our collective native experience nor is it necessarily ethically sound.

CPD is about to be embedded directly into assessing our psychotherapy credentials and our level of experience. Continuing professional development is a natural response to maintaining an active interest in what we do. It is of course a logical and reasonable hope to hold, that we would continue to be stimulated sufficiently in the work we do so as to retain a hunger for more understanding and more experience, a naturally occurring event.

We may soon be required to fulfil a significant number of hours taking part in what will be identified as valid CPD in order to just stay in practice. Presumably this is to demonstrate our commitment to individual ongoing development as therapists. That is certainly a fair and ethical request in the contexts of professional responsibility and of transparency. Unfortunately CPD as an assessment tool is not a true indicator of a therapist’s deepening capacity for providing psychotherapy. Proof of attendance at or participation in a therapy related event or situation is simply that, an attendance list, a form of roll book. It may alleviate anxieties with trusting psychotherapy and those who practice it but it does not fulfil a requirement for manifesting ongoing self-development with any efficiency. Our level of experience with individuation and our capacity for understanding and engaging with our humanity can not be reliably assessed mathematically from a multiple of hours and attendance. What is it about each other that we are attempting to measure with this style of yardstick?

Making participation in CPD an accreditation requirement could be said to leave all of us in a state of permanent apprenticeship. The day after we are accredited or re-accredited we will once again be in a state of needing additional hours of CPD in preparation for the next accreditation and so we will never in our working life get to a point where we can say; I am now formed and satisfactorily proficient as a therapist and I can be trusted with holding this position in an ethical and informed manner. Perhaps we could be required to demonstrate in a more personal format such aspects as: what interests me further, what areas I am continuing to explore, what I see as challenging to me in how I work. There would be much more valuable and vital information made available in such a format with regard to taking the pulse of psychotherapy and assessing the trustworthiness and commitment of therapists.

The basis of the IAHIP definition links the phenomenon of individuation and the organismic ground of this with a theoretical perspective that is humanistic and integrative in practice and application. It is essential that any applied CPD requirements or any other criteria, which we will soon be required to individually and collectively accept , are linked specifically to the fundamental geometry of our professional orientation:

2.2 “…seeking to attain integration in the wholeness of body, feelings, intellect, psyche and spirit, and in relation to other people.

Understanding sufficiently the experiential dimensions of individuation is a core requirement to adequately fulfil this description. We need clear guidelines for identifying what constitutes valid clinical participation in the experiential layers of our relations with clients process work. These are structured from energetic, organic, experiential maps which compliment the academic ability to be accurately present. That’s where the pulse surely can be found.

There is talk of a further corral to be put in place. The possible requirement for a primary degree in order to be seen as fit to train in a psychotherapy approach that embraces individuation. Would that not be a contradiction? The integrity and depth of experience current within IAHIP members suggests there is no obvious value in forcing a degree status on human beings who have a capacity to become therapists. Such a limitation risks censoring a connection to a fertile ground of genuine human experience and disconnecting from it. That would hardly mirror the spirit within the Code of Ethics we agree to follow.

Perhaps we can find a reliable means to assess the capacity in therapists to attend to individuation as we describe it for ourselves. That is a reasonable and logical requirement. Some day there may be a degree for understanding the experience of deep internal suffering. That will obviously take another paradigm shift in society. For some the paradigm dial is already shifting into reverse again with positions like the recent one in a related association that states forty hours supervision training takes precedence over forty years experience. We will not follow that wisdom, will we?

The timid concept that information confers integrity and that academic knowledge confers wisdom is well worn out but still very active in the world. “I think therefore I be” to distort a well known phrase. Let’s not inadvertently create rules that could imply a willingness on our part to be seen as untrustworthy or confused in what we do. We are not anarchists or saints or martyrs or gurus or politicians we are humans. We all share a commitment to navigating that experience. The core humanistic dynamics are solid, their application has proved solid, and the research confirms that solidity. So too do the myriad of people who have and will continue to benefit from the efforts therapists make to be present in effective and therapeutic ways.

It is of course logical and reasonable to want to stay in the loop that currently predominates in our culture regarding how standards are set and assessed. We are also committed, by our ethics, to having one foot outside the loop. That is the place that growth emerges from. We follow the tracks made by many trustworthy therapists who ventured there and we must maintain and nurture our individual ability to continue exploring in that direction. The checks and balances we accept as capable of effectively revealing what we do must be fine tuned in our direction and expressed in a language that safe guards the central criteria we adhere to. A question needs to be continuously answered in all of this. What is it specifically about going in these directions that will enhance and best express what we practice? We must attend to our humanistic roots and ensure their survival in any replanting or re-orientating that is about to take place. The Code of Ethics we follow and the experiential heart of our approach must hold precedence over what guides our decisions and agreement.

Paddy Logan is an aging apprentice of humanistic and integrative psychotherapy.

He is a partner in the Integrative Psychotherapy Practice in Rathmines, Dublin.