Dr Kev Harding works as a clinical psychologist across the North West of England
© Harding 1471-7646/16/02134-11
June 2016 Kev Harding 135
2014). Such research has underpinned the rise of ‘Improving Access to Psychological
Therapies’ (IAPT), which gives the impression that if people just change how they
view themselves (to be done in a matter of weeks, evenly numbered in multiples of
four i.e., 4, 8, 12, or 16 prescribed sessions of CBT) then their ‘condition’ or ‘illness’
can at least be ‘managed’, and maybe they will even ‘recover’ (whatever that means)
if they follow the script and do their homework diligently. They can then return to
work and stop costing the tax payer money (Layard, 2006). This fits seamlessly with
the UK Government’s rules for anyone unemployed who is claiming benefits, where
they must show evidence that they are looking for work or face the possibility of
sanctions (i.e., losing means to live and survive).
The ‘sanctions’ of psychiatric medication or prescribed CBT (when it doesn’t
‘work’) are likely to be labels of ‘treatment resistant’ or ‘personality disorder’. Both
modern psychiatry and clinical psychology are permeable with the ideas described
above and dominant in Western culture: that each individual has the power to
shape his or her own destiny regardless of circumstances (Moloney, 2013). One
manifestation of such ideas reside in the plethora of books describing how various
‘celebrities’ have ‘overcome the odds’ and made a ‘success’ of their lives (usually in-
between stints in private therapy etc.). The message that if ‘they’ can do it… so can
you!’ implies that a person’s problems are within and can be ‘cured’ by taking the
‘right’ pill, ‘working harder’ in therapy, or a combination of the two. The current
popularity of Westernised Buddhism aka ‘mindfulness’ can also advertently or
inadvertently support such views with its message of focusing on ‘the present’ and
‘letting go’ of such pesky emotions as anger. That’s not to suggest that ‘mindfulness’
(or even tranquillising pills) cannot be helpful for some people at times (especially
in a position of little power to change things), but there are some philosopher’s like
Slavoj ŽiŽek who write persuasively of how such an attitude might facilitate people
becoming more accepting of a neo-liberal status-quo which isn’t in their best
interests, but rather that of multi-national companies instead i.e., are you stressed
through overwork in your job? If so then practice mindfulness, which might
help reduce your anxiety (for a few minutes) by helping you retreat to your inner
world from the harsh real world of job insecurity and overwork. However, this
may deepen a person’s resigned acceptance of the idea that there is no possibility
of meaningful change to the current ‘status quo’ (especially now Trade Unions
seemingly have little or no power to improve ‘work-life balance’ for people). As
ŽiŽek (2009) suggests:
(Westernised Buddhism allows us to) fully participate in the frantic pace of the
capitalist game, while sustaining the perception that you are not really in it,
that you are well aware how worthless the spectacle is – what really matters to
you is the peace of the inner self to which you know you can always withdraw.
136 The Journal of Critical Psychology, Counselling and Psychotherapy
So the idea that psychotherapy ever ‘cures’ people in some sort of pseudo-medical
way (i.e., eight sessions of CBT will ‘cure’ your ‘anxiety disorder’ like antibiotics
June 2016 Kev Harding 137
cure a sore throat) can be dismissed in the same way that Layard (2006) seems
to dismiss the significant methodological flaws of the ‘evidence base’ he lauds
(Moloney, 2013), because such an idea is not something that can ever be objectively
‘proven’, though the psychotherapy professions do try (and fail). For example,
Epstein (2006) thoroughly reviewed what was considered to be ‘credible’ evidence
from ‘credible’ journals and concluded that:
… there has never been a scientifically credible study that attests to the
effectiveness of any form of psychotherapy for any mental or emotional
problem under any condition of treatment.
To believe that man is the author of his destiny is not to deny that he may be
tragically limited by his circumstances. I saw too many unfortunate youngsters,
some of them literally starving in that depression-ridden dustbowl, for me not
to be aware of their tragic limitations. Clearly there were things they might like
to do that circumstances would not permit… But, nevertheless, there was still
an infinity of possibilities open to them (Kelly, 1955)
So Kelly wasn’t suggesting that his theory of PCP was a prescribed ‘fix’ or ‘cure’
like some CBT practitioners seem to suggest (see Moloney, 2013). Nor did it place
the ‘responsibility’ for a person’s difficulties squarely with the person like IAPT
inspired manualised CBT (Layard, 2006). But Kelly did offer the possibility that a
person could reconstrue their difficulties in ways which might help them to live
their lives better, and so PCP might in a philosophical sense offer some worthy
consolations. Above all, he offered a theory which suggests:
… human freedom is not freedom from conditions, but rather freedom to take
a stand; to face whatever conditions life presents us with. (Frankl, 1997)
folly of a ‘one size fits all’ approach to psychotherapy. He proposed ‘three main
ways’ to ‘meaning fulfilment’, firstly by fulfilling creative values i.e., creating a
work or doing a deed; secondly by experiential values i.e., taking in a sunset or
encountering someone; and thirdly by attitudinal values i.e., the attitude a person
takes towards unavoidable suffering. There are obviously numerous examples
that could be conceived for all three values and of course what one person finds
meaningful another person might not. However, Frankl (1997) was keen to point
out that if a person was depressed and felt that life had no meaning for them then
this wasn’t necessarily due to a ‘mental illness’ but rather evidence of the person’s
human dilemma (the idea in this notion that to the best of our knowledge ‘no
animal ever concerns itself with contemplating the meaning of existence in
contrast to mankind’ Frankl, 1986) and need to find a philosophy that is helpful
for them to live by. It is well documented that Viktor Frankl was tragically able
to test out his theories personally, when he was incarcerated in Auschwitz –
Birkenau for close on three years during World War II. His immediate family
were all murdered in the gas chambers. Despite these grimmest of circumstances
Frankl wrote that:
We who lived in concentration camps can remember the men who walked
throughout the huts comforting others, giving away their last piece of bread.
They may have been few in number, but they offer sufficient proof that
everything can be taken away from a man but one thing: the last of the human
freedoms – to choose one’s attitude in any given set of circumstances, to
choose one’s own way (Frankl, 1997).
Clinical practice is always determined and influenced by the view of the human
being that the clinician brings to the client, even though it may be hardly
conscious and controlled (Frankl, 1986).
For the purposes of this paper, the above quote from Frankl demonstrates the
differences between the idea that ‘mental health problems’ have their roots in ‘faulty
June 2016 Kev Harding 141
but they may also decide that life is still worth living rather than contemplating
suicide. This might be construed as psychotherapy providing consolations but it
doesn’t constitute a ‘cure’ because the person wasn’t ‘defective’ to begin with. Such
limited consolations seem no different to those offered by ancient philosophers
like Seneca over 2000 years ago (De Botton, 2001). So much for the ‘up to date’
(pseudo) scientific assertions of IAPT inspired CBT…
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