Psychotherapists and Counselors for Social Responsibility (UK)
Andrew Samuels
The following is a brief report about one of the psychotherapeutic/social action organizations that I have helped to found in the UK—Psychotherapists and Counselors for Social Responsibility (hereafter PCSR). It's a report, not a theoretical statement or a history of such organizations, which have existed or do exist in many countries. Inevitably, the report has its parochial features, and I will let readers work out how what follows does or does not align with their own experiences in their particular locations.
The long-standing desire on the part of many psychotherapists and psychoanalysts to make a contribution to the alleviation of social as well as personal distress has often foundered when it comes to the matter of organization.1 Psychotherapists are incorrigibly disputatious, and pervasive worries about 'neutrality' contribute to a picture in which the intent to bring "therapy thinking" into a wider world is undermined. There may also be conscious or unconscious wishes to conform to whatever standards seem to fit with the prevailing ideology of the day (see Jacoby). In general, then, it has not been easy to find an organizational vocabulary that will articulate "therapy for the world" in the face of the world's indifference or even hostility to what can sometimes seem crass psychological theorizing about complicated sociocultural and political conflicts. In my view, it is because politics involves conflict and struggle that it is so difficult to work out a psychotherapeutic approach; therapists tend to seek a pre-existing internal or external conflict that a client is experiencing, so as to explore or mediate or synthesize such conflict which, pace relationality and intersubjectivity, is not often one they are involved in as direct participants. We are better at being thirds in any bilateral conflict situation—"why don't you and he fight?," as the bar wit put it.
Our record in terms of political awareness and respect for difference and diversity, whether sexual, ethnic or in terms of lifestyle, is not a terribly impressive one. Too many of our theories are Eurocentric, normative, bourgeois—or just prejudices dressed up as theories. And, to round off this somewhat depressing litany about the inadequacy of psychotherapy as basis for a political organization, the politics of the profession seem to many insiders as well as to informed outsiders to be grotesque, preoccupied with status and hierarchy, and bedevilled by crude character assassination.
Very much aware of these problems, a group of psychotherapists in the UK got together in the mid-1990s to set up PCSR. The fact that counselors were involved in this as well as psychotherapists from many different orientations gave the new organization a unique flavour in the class and faction ridden psychotherapy scene in the UK. The general idea was for psychotherapists to find a collective voice as psychotherapists and, having found their generic voice, begin to make constructive interventions in areas where psychotherapeutic expertise seemed relevant, such as "the family," pornography, crime and punishment and mental health practices generally—and subsequently in areas of "hard" policy, such as economic strategy where the case for the utility of therapy thinking seemed at first to be weaker (for illustrations of "soft" and "hard" policy fields from the view of the politically oriented psychotherapist, see Samuels, Political Psyche, esp. Chs. 3, 4, 5).
The mission was to incorporate emotional and psychological perspectives into current debates on social, cultural, environmental and political issues—without falling into a "psychotherapy reductionism" which would be distasteful and counterproductive. The hope was to engage policy makers in dialogue and address the media in ways that acknowledged diversity and discouraged polarized thinking. The organization clearly intended to be an active one rather [End Page 150] than one that restricts itself to the development of theoretical perspectives, and this was illustrated by a passage in the initial recruitment leaflet that dealt with the question of whether members would be expected to go on demonstrations as psychotherapists and what would happen if their clients saw them on the demonstration (The consensus was that this would always be up to individuals and that no-one who declined to attend a demonstration or public meeting should feel ill at ease in the organization as a result. The fact that the debate on the topic at the inaugural meeting was held in a London theatre and not at one of the profession's usual venues, was itself illuminating).
If the first strand of PCSR's mission was to incorporate the psychological into the sociopolitical, the second strand of PCSR's activities was to try to locate psychotherapy and counseling in their sociopolitical context, working the other side of the street, as it were. Societies make demands on groups of people working and living within them and, though therapists might imagine themselves immune from such demands, we could see that we were not. The question of making a living, and hence the kinds of clients seen, and what the goals of our work might be, could not be looked at exclusively as "professional matters"—you could say that we considered the professional to be political. It followed that, whatever the various roots of "countertransference" in the therapist might be, it could not be satisfactorily understood as restricted only to her or his personal dynamics, conscious or unconscious; there are cultural, social and political dimensions to countertransference. Once this perhaps rather mundane insight was acted upon seriously, it helped many of us not only to recognize the impact of the political dimension on the relationship between practitioner and client in terms of power dynamics and the working out of their manifold differences, but also to think about operationalizing the insight.
The result has been some thinking about how practice might incorporate social, political, environmental and cultural issues—in their own terms, without symbolic interpretation or a search for the infantile roots of political preoccupations and positions in the client. Hence there would be a firm clinically grounded base from which to address racism, sexism, homophobia and other forms of prejudice and discriminatory practice. There was always ambivalence about PCSR's campaigning for better provision of psychotherapy and counseling services across the country because this could look like self-interested pleading, but there was general agreement that the social self-definitions of many psychotherapists, together with their typical practices with well-off private clients, might need some fresh thinking. In general, most, but not all members were distinctly left of center in their personal approaches to politics, and there was and continues to be a strong presence of those who grew up in the 1960s.
The organization set up topic groups to focus on issues of concern, and over time these have included social policy, gender, sexual diversity, education, politics, families and children, international issues, race and culture, refugees, prisons and violence, society, ecopsychology, and economics. There are three regional groupings of PCSR (which is very significant in a highly centralized country like the UK), and in June 2002 an important meeting was held in Portsmouth (a naval town in decline on the south coast) in which representatives of PCSR engaged in a public dialogue with senior officials from the local health, welfare and educational services. What was interesting to me at this meeting was how linkages between politics (broadly defined) and spirituality (even more broadly defined) could be uttered in ways they could not have been just seven years earlier. Psychology and psychotherapy stood at a midway point between the material and spiritual dimensions of experience. At this meeting, we found that it was both necessary and possible for staff members with profound doubts about their duties to express these doubts in three ways: legalistically, emotionally, and in terms of moral and spiritual values.
Membership of PCSR peaked at 650 (which was a quite incredible figure) but has now settled down at 220-250 (there are about 5000 psychotherapists and about 1000 qualified counselors in the country; the scene is very small compared to the US). Money is a perennial problem and is raised by [End Page 151] a rather low membership fee plus profits from conferences and workshops.
Now for the problems, of which there have been many. A central one, if I am blunt, was that many of the first cohort of psychoanalytically oriented psychotherapists found it very difficult to work with their integrative and humanistic colleagues and quite a number dropped out. Gradually, others joined but I fear that this phenomenon is not something that is restricted to the UK. For example, there are current attempts in the United States to set up similar organizations, but the psychoanalysts initiating the projects do not seem to be contacting humanistic practitioners, such as Arnold Mindell or Joanna Macy, or Jungians such as Polly Young-Eisendrath and John Beebe, or ecopsychologists such as Theodore Roszak—all of whom would provide somewhat different approaches to psychoanalysis but would, nevertheless, be unlikely to fail to fit in at all.
A second problem for us was that PCSR's first public action involved spearheading the campaign to protest the manner in which an invitation was issued on behalf of psychotherapists in the National Health Service to Professor Charles Socarides, whose views on the psychopathological nature of homosexuality are undoubtedly well-known to readers of this journal. This protest led PCSR into an extremely vicious and protracted campaign to remove the discriminatory bars to acceptance for training of lesbian and gay candidates set up by the Institute of Psychoanalysis and other leading psychoanalytic psychotherapy training bodies. Although ultimately successful, but only after having deliberately involved the media and the Department of Health, this campaign did lead to a general vilification of PCSR by the organizations affected by our campaign, which accused PCSR of being composed of disturbed individuals with axes to grind. In spite of liberal protest and the achievement of the campaign in making it impossible for institutes to bar homosexual candidates, homosexuality remains "the symptom" of British psychotherapy, and what is taught about sexual orientation in many training programs continues to be quite dismayingly prejudicial. PCSR did not pick a cause likely to be popular with professional colleagues, but it was the hot issue at the time the organization formed.
The third problem that I want to note concerns the general difficulties psychotherapists have in being taken seriously in either mainstream politics or as resources for more activist groups. In spite of the relative impact that certain individuals, such as Susie Orbach or myself, have had, the general response is either that psychotherapists are saying things that are so damn obvious you don't need to be a trained therapist to say them—or that psychotherapists are only able to speak in impenetrable jargon-ridden psychobabble. One should not forget how unpopular psychotherapy is in this country—it is still seen as an exotic and oversensual import from deranged Central Europe.
On the brighter side, the main achievement of the organization has been that it acquired a certain status as the public voice of psychotherapists when political issues were on the agenda. The official bodies in the psychotherapy field have found themselves unable to get involved in such matters, maintaining that these fall outside their remit. This left a vacuum. Some examples of PCSR's influence are the campaign to achieve decent conditions (psychological and material) for pregnant women prisoners and an attempt to understand the troubles in Northern Ireland from a more psychological point of view—this led to many letters and articles in the press and to an extremely interesting conference. One thing that we have not managed to achieve is to promote the organization as a professional body in the conflict resolution field. We have stayed more on the level of campaigning, agitating and informing—though several members are very experienced mediators and conflict resolvers.
I will conclude by saying that organisations like PCSR both depend on and lead to changes in practice. Today's "bad" practice, for example one that actively involves entering into political discussion with the client, can be tomorrow's indispensably "good" practice. In fact, the history of psychotherapy as a praxis can be construed as the regular breaching of clinical taboos—working with children, treating psychotics or borderlines, self-disclosing would [End Page 152] be just a few examples of the general process wherein what is initially condemned by the orthodox gradually moves center stage.
In the early 1990s, I conducted a large international survey to look
into what psychotherapists and analysts did when confronted with
political material in the clinical setting (Samuels, Political;
Replies). Space does not permit an adequate summary of this
research but two things stood out. First, clients bring such material more
frequently than they used to. Second, the clinicians are often completely
at sea when confronted with such material. There is still a lack of
books and articles on this topic and I freely admit to my own ongoing
perplexities in this area (see Samuels, in Reppen; Politics).
Andrew Samuels is Professor of Analytical Psychology, University of Essex, Visiting Professor of Psychoanalytic Studies, London University, and a Training Analyst of the Society of Analytical Psychology, London. Board Member, International Association for Relational Psychoanalysis and Psychotherapy and former Scientific Associate, American Academy of Psychoanalysis. He is in private practice and also works internationally as a political consultant. His many books have been translated into 19 languages and include The Plural Psyche: Personality, Morality and the Father (1989); The Political Psyche (1993); and the award-winning Politics on the Couch: Citizenshipand the Internal Life.
Works Cited
Craib, Ian. Psychoanalysis and SocialTheory: The Limits of Sociology. London & New York: Harvester Wheatsheaf, 1989.
Jacoby, Russsell. The Repression of Psychoanalysis: Otto Fenichel and the PoliticalFreudians. New York: Basic Books, 1983.
Samuels, Andrew. "Replies to an International Questionnaire on Political Material Brought into the Clinical Setting by Clients of Psychotherapists and Analysts." International Review of Sociology 3 (1994): 7-60.
____. "The Political Psyche: A Challenge to Therapists and Clients to Politicize What They Do." In More Analysts at Work. Ed. Joseph Reppen. Northvale NJ & London: Jason Aronson, 1997. 155-182.
____. The Political Psyche. London & New York: Routledge, 1993.
____. Politics onthe Couch: Citizenship and the Internal Life. London: Profile Books; New York: Other Press, 2001.
Totton, Nick. Psychotherapy and Politics. London & Thousand Oaks: Sage, 2000.
