I gave this talk to clinical psychologists in Nottingham at the time of my retirement from the NHS in 1998. I hadn't put it on the website until now (ten years later) because some of it seemed too personal and informal to be of general interest. But, having read it over again more or less by chance, it seems to me that it does say some things at least as directly and clearly as I have said them elsewhere, and perhaps the personal element, even if slightly enigmatic in places, is not without interest.
Valediction
Well, it’s difficult to know what kind of line to take on an occasion such
as this. In fact, as far as my own personal life is concerned, there aren’t
occasions ‘such as this’: it’s a unique occasion. And so: how
to sum up, or reflect upon, a huge chunk of one’s life? What kind of tone
to adopt? There is a wide range of possibilities. Up-beat or down-beat; sadly
nostalgic or (at least in theory!) cheerily optimistic; warmly grateful or prophetically
admonitory; confident or (very temptingly!) apocalyptic? All of these are just
about equally possible, each having its own validity.
What I can say is bound to be shaped by my audience, and this today is not any
old audience. There are here some colleagues and friends of many years’ standing,
and also one or two people I haven’t really even met. Older and relatively
new hands, people who know how big a pinch of salt to add to my utterances as
well, perhaps, as others I must be careful not to traumatize by, for example,
giving vent to too bleak a vision of the future of clinical psychology. (This
occasion could turn out to be, in a manner of speaking, the Christmas Eve of
all Christmas Eves!) It’s also going to be difficult to get the right balance
between the personal and the professional.
When I ‘semi-retired’ five years ago it was relatively easy to make
the choice of a short, semi-humorous speech. After all, we were having a party,
I knew everybody there pretty well, I was extremely glad to be giving up the
thankless job of being a head of department (which at the time meant having quite
a bit of responsibility for transmitting totally unpalatable ‘management’ policies
and virtually no power to resist them) and, in any case, I wasn’t really
leaving. That party remains one of my warmest memories.
This time, though, I really am retiring, so there are, for me, some darker tones
around. Certainly I’m utterly relieved to be getting away from all the
managerially induced upheavals in clinical psychology locally and nationally,
and the prospect of not having to deal with all that makes it surprisingly difficult
to display the proper sympathy to those of you who are having to bear the brunt
of it; I’ve no doubt that my cheerful indifference to adversity must have
got thoroughly on some people’s nerves recently. But I hope you will allow
me that small indulgence. There’s not really all that much that’s
cheerful about retirement, and it’s a strange and far from comfortable
feeling suddenly to find oneself largely stripped of public significance. It’s
quite surprising in fact how people can sense one’s altered status - and
not, I think, just from the appearance of age. A note of patronage comes into
people’s voices; one is suddenly like a child again. This was epitomized
recently for me by a woman at a Sainsbury’s checkout, where I was, as far
as I’m aware with no less efficiency than usual, doing the Friday shopping: ‘Would
you like some help with your packing, sweet heart?’, she asked, slowly
and clearly.
I’d probably feel much sadder about losing daily contact with colleagues
I’ve been working with - some of course for many years - if we had not
already become so splintered and scattered that we see each other only rarely
anyway. With luck I may almost see more of people after I retire than I do at
present, and one comforting thing is that I don’t feel that the people
I’ve come to know so well will be any more inaccessible. Just about the
nicest thing about having been the head of a fairly large department for a long
time is the comfortable familiarity I feel I have with colleagues of like mind
and long shared experience. ‘Familiar’ is exactly the right word
in this context: Nottingham clinical psychologists have long been - for me at
any rate - a kind of extended family, and it is only having you around, especially
to have a good moan to, which has made the last years bearable.
It’s certainly - and obviously - more the public than the personal aspect
of one’s life which is, so to speak, injured by retirement, and none of
that is made easier by the dreadful set-backs we have experienced in Nottingham,
at least in some parts of the service, and particularly in that part with which
I have personally been most closely associated. What an irony that the very day
I leave will be the day we are moved back to St Ann’s House as kind of
reluctant guests in a cramped room of a building which once we were not far off
occupying totally as a unified District department of clinical psychology!
One of the - at least as far as I’m aware - less remarked-upon but most
significant contrasts between older and younger people is the difference between
the span of their memory. Looked at from the perspective of an older clinical
psychologist, what may seem to a younger colleague something like progress can
look more like a major setback. For example, I came to Nottingham in 1968, when
clinical psychology was on the up - our professional status and pay, our independence
if not exactly our power were definitely waxing rather than waning. When I first
came here as a thirty-year-old Principal Psychologist and head of the Nottinghamshire
Area Psychological Service, I had a nice, big, newly furnished office at Saxondale
with a secretary in an adjoining room, plus an (admittedly rather less sumptuous)
office at Mapperley. There was me, an elderly Senior psychologist and three probationers,
each of whom had at least one office of their own. We expanded steadily from
that point on, and after a short time I was answerable as head of the service
directly to the administrative head of the NHS Area, which meant the county of
Notts. Probably our principal professional concern was to get out from under
the shadow of psychiatry, and we did that pretty successfully, the biggest step
probably being when we moved out of St Ann’s to take up residence in the
Community Unit at Memorial House.
Well, events have of course since then reversed that process pretty well totally,
and although some younger colleagues, coming here perhaps quite recently and
aware only of contributing to an apparent expansion in their part of the service,
might find it hard to understand why, it is certainly impossible for me to survey
the current scene with a great deal of satisfaction. But of course, the thing
about ‘post-modernity’ is that it has no history, and we have perforce
to live our lives in the present. The fact that I can see plenty of spilt milk
to cry about will not, and should not, cause those of you who have many years
yet to develop your careers to lose too much sleep.
Mind you, it is not that, despite all the recent set-backs, there hasn’t
overall been considerable advance, and our earlier struggles were not by any
means completely in vain (though only the older generation of clinical psychologists
will fully appreciate their significance). Reading a biography of Carl Rogers
recently was a salutary reminder to me of how things used to be and how, thankfully,
they no longer quite are. For example, even at the height of his success in developing
client-centred therapy, Rogers was beset by problems with psychiatry, in one
particular case harassed by a junior psychiatrist insisting that he, Rogers,
should not see patients without medical supervision. I can remember only too
clearly that kind of hassle, but it’s hard to imagine such things being
quite that bad these days.
I realized rather to my surprise when I thought about it recently that my working
life almost, though not quite, coincides with the history of clinical psychology
in this country, and if this - as I think it could be said to be - is the century
of therapeutic psychology, I have been around for more than half of it. I’m
not sure, if I had my time over again, that I’d choose to do psychology,
but in the 1950s there seemed to be no reason to hesitate. The origins of therapeutic
psychology seemed at that time more or less contemporaneous: Freud was hardly
cold in his grave; Jung was not yet in his; Eysenck was, so to speak, a young
Turk; news of Rogers’s ideas and approach had only just begun to filter
across the Atlantic. It was a field full of promise and excitement, the power
politics veiled behind what looked like - and to a large extent really were -
debates and battles about ideas. The therapeutic community movement, which I
became involved in very soon after taking up clinical psychology, was as near
a genuinely idealistic enterprise as one can get. Work, then, was completely
absorbing and rewarding in every way but materially (the only thing that clouded
the horizon in those days was acute and persistent worries about money).
Clinical psychology was a nascent rather than merely a young profession - indeed
I think there are arguments to be made that it is still quite a long way off
becoming a profession at all in the strict sense - but even then the political
issues were, as they have been ever since, uppermost. Our struggles were chiefly
with medicine, and in the early days of my career it was quite difficult even
to talk to patients (as opposed to quizzing them psychometrically) without feeling
guiltily that one was over-stepping the limits of one’s professional competence.
Over the 60s and 70s we won a lot of battles with psychiatry, and much more quickly
than I think we thought we would. Partly this was due to the efforts of politically
relatively sophisticated psychologists, most of whom nobody much remembers any
more (or indeed has even heard of) - Mahesh Desai, May Davidson, Eysenck of course,
Don Bannister - but mostly, I suspect, because a relatively benign NHS regime
was able to see for itself that clinical psychologists were for the most part
decent, rational people constructing a genuine alternative to the medical model
which dominated then, as it dominates now, through the skilful application of
power rather than the exercise of reason. Arguing for our interests as head of
department, I could pretty well rely on a degree of impartial intelligence on
the part of those administering the NHS locally (and by extension nationally),
and if you could make out a reasonable case for something there was a pretty
good chance you would get it backed with at least moral support.
All that changed, of course, with the advent of the Thatcher government, but
the social upheaval of the past two decades was not easily foreseeable in the
60s and 70s. Indeed, there was a period in the 70s when I really began to think
that the intellectual and scientific bankruptcy of psychiatry would lead to its
demise. The foolishness of that hope was brought home to me recently when I confessed
to having entertained it to none other than the great Thomas Szasz: he shook
his head in slightly worried concern for my soundness of mind. Psychiatry is
an essential part of the societal apparatus, and as such can talk any sort of
nonsense it likes without fear of disqualification.
By contrast, clinical psychology doesn’t really have a power-base. For
a while we enjoyed a degree of political patronage, but we haven’t yet
learned that appeal to reason butters no parsnips, and I don’t think we
really have the first idea of how to set up and maintain a profession in the
way that, for example, doctors and lawyers do. We don’t really understand
the workings of power, and too many of us think it’s just a dirty word.
Temperamentally, it seems to me, clinical psychologists are all about reason
and reconciliation, and to function effectively we have always tended to look
to the protection of power rather than its acquisition and exercise. A salutary
lesson for me in this respect was when we as a department called an extraordinary
general meeting of the DCP a few years ago. We caused consternation, certainly,
and we rocked the boat a little - we may even have done some good in the sense
of helping indirectly to avert some of the undesirable developments we anticipated
from the MAS report - but the one thing we didn’t do was ignite any real
political feeling in the membership. As far as I can see we don’t really
have any professional politics, other perhaps than little flurries of political
correctness on some issue or other about which everyone scurries to agree. We
don’t, I believe, argue nearly enough with each other about the best means
of achieving our professional goals.
Maybe this is because we aren’t all that clear about what our professional
goals should be. Certainly I often think that our concern to placate and become
reconciled with the powers that be leads to our losing sight of what we actually
stand for, to the extent that we ourselves find it hard to differentiate our
own activities from those of other professional groups; an example would be the
question of what makes what ‘adult mental health’ psychologists do
different from what CPNs do. We’re so busy trying to dance to the tune
played for us by managers that we fail to point out that it’s just the
wrong music. The fact is though that clinical psychology does stand for something,
and something too important for society to be able to afford to ignore it. And
that is precisely that there is an alternative to the medical model, and the
counselling model, and the ‘psychoanalytic psychotherapy’ model,
and it is one that only we have developed and only we know how to practise. But
if people haven’t got the wit (as maybe they had - more - in the 70s) to
see that this is the case, we have to concentrate very hard on developing the
sheer political toughness, as well as the formal political apparatus, for asserting
our case and protecting our position. In my view this will not be achieved in
the time-honoured way so often advocated by our leaders (most recently Glenys
Parry at one of these very meetings), i.e. of making friends and influencing
people by personal example and ‘psychological’ manipulation. We have
in fact been seriously shafted in recent years by a kind of alliance of interests
- mostly management but partly medical - and I simply don’t believe that
we couldn’t have resisted this more effectively than we have.
Perhaps one of the chief difficulties confronting those of us who work in the
adult mental health field is to be clear about what is psychology and what is
therapy and to be able to differentiate the two. The trouble is, of course, that
both psychology and psychotherapy each encompass parts of the other: it’s
hard to develop an accurate psychology without continuously testing it in practice
with people, and it’s impossible to practise psychotherapy without operating
an at least implicit psychology. If, then, you focus on the practice of therapy
and counselling (as NHS managers do almost exclusively) the common elements of
all forms of ‘treatment’ make it look as if everybody’s doing
the same thing - and indeed to a very great extent everybody is doing the same
thing. But psychology, in my view, is not - or at least should not be - about
the practice of treatment so much as about the explanation of psychological distress.
It is in the psychological component of our work that our role is unique and
important. It’s my impression that we have as a profession taken our eye
off this ball over the past twenty years or so - ever since, in fact, we so determinedly
took the road of professional practice (as opposed to scientific investigation)
in the 70s. Most clinical psychologists, I suspect, joined the service in the
hope and expectation of being directly helpful to patients, and so the enthusiasm
with which we adopted the therapist rather than the boffin role is entirely understandable.
But treatment turns out to be less a technical procedure justifying extensive
professional training and more a kind of open-ended, human undertaking which
depends for its success more on the person than the procedure. It’s more
an art than a science, and there’s nothing to guarantee that clinical psychologists
- or any other professional group come to that - are more gifted at it than anyone
else.
In this respect I’ve found it very interesting saying goodbye to patients
over the past few weeks because of my retirement. Some I’ve known for a
very long time (the longest 18 years) and some for just a few sessions. At this
- final - stage of my career I don’t, I think, have too many axes to grind
and I don’t have to kid myself about the effectiveness of ‘treatment’ or
justify my practice to the judgement of any present or future authority, and
although I could not possibly be said to be free from prejudice in the matter,
there is a very strong sense of being able to see and to say what has been helpful
to people, and in that process there is an even more striking lack of technical
pretentiousness than I would have anticipated. The fact that I’m going,
that I shall have no future expectations of them and they no future demands on
me, somehow makes the saying goodbye very direct and uncomplicated, and puts
- I think anyway - what has been achieved, and indeed not achieved, in an unusually
clear light. There seems, anyway, to be surprising lack of mystery about it all,
and to understand the essential processes involved in therapy seems to require
little more than a reasonably unprejudiced common sense.
There is no doubt that to a few patients, in particular those of long standing,
I have been very important as a person, as a figure in the human landscape. And
there is a striking one-sidedness to it - the one-sidedness which is the defining
feature of the therapeutic relationship. I know huge amounts about them - probably
more than anyone else in their lives - and they know next to nothing about me.
Even so, in the gratitude and affection of one or two people I can sense the
reality, so to speak, of those aspects of me which have been important to them.
Although they know nothing about me - or very little - they still do know me
in very direct, even intimate, ways. They have found resources within me which
they have been able to make good and positive use of, and there is an element
of grief in their loss which, somewhat surprisingly, I haven’t felt at
all guilty about. I don’t feel I’ve exploited their feelings and
I don’t feel it would really be possible to help many people without their
forming this kind of attachment and incurring sooner or later this element of
loss. Life is full of loss, from start to finish, and loss is not necessarily
so much damaging as simply inevitable. You may lose a person, but you don’t
lose thereby what that person meant to you or helped to establish within you.
With one or two very much more recent patients I’m very aware of having
helped them quite profoundly and quite quickly, again not by virtue of any technical
procedure but because we’ve been able to clarify the core of their difficulty
in ways I’d be hard put to it to specify, but which called upon a mixture
of experience, scepticism, a kind of sixth sense for what makes sense and what
doesn’t. Plus the all-important ingredient of being totally on their side,
a recognition of moral fellowship, and acknowledgement of frailty, both theirs
and mine. Very little of this has to do with being a psychologist and a great
deal has to do with being a human being.
Not all patients, I should say, fall into these categories. In saying goodbye
to people it has also been noticeable that there have been quite a few - perhaps
the majority - who, though they have I think appreciated my services, have developed
no special attachment to me and are happy enough to be passed on to someone else.
It is the largely impersonal elements of the role they have found useful - simply
having someone to listen sympathetically, etc. - and neither they nor I have
any doubt that another therapist, whether clinical psychological or not, would
be equally useful to them.
Thinking about the role of therapist in general, what strikes me particularly,
trite though it is to say so, is its similarity to the more traditional role
of priest. But with (at least) one crucial difference, and that is that we are
not so much mediating between the individual and a divine mystery, interpreting
the will of God to the ordinary punter, so to speak, but actually mediating between
the individual and reality, interpreting the person’s experience in the
light of the demands and constraints of the world in which s/he finds him/herself.
Like priests, we relieve people of the burden of guilt, but not the guilt of
sins we construe them as having committed, but sins of which they are for the
most part falsely accused within a punitive social ideology. If conventional
priests are brokers of illusion, psychotherapists are, or should be, diagnosticians
and dispellers of illusion, helping patients identify and engage with realities
of their lives which had for one reason or another become obscure to them.
This is a very large claim to make (though, one may note, considerably more modest
than the credentials claimed by the conventional priesthood!) and I don’t
pretend to know how to justify it. All good therapists, in my experience, operate
with a refined, accurate and observable sense of what is real and what is illusion,
but nowhere in the therapeutic literature, that I can think of anyway, is this
sense adequately documented or intellectually elaborated.
But if it’s impossible to define this sense, it’s by no means all
that unusual to see it in action. For example, groups of colleagues listening
to recordings of therapy sessions can often pick up and agree about extremely
subtle indications of the truth or authenticity of what someone is saying. At
the easiest and most obvious extreme, most people have no difficulty identifying
bullshit (the audience of Blind Date, for example, is often noticeably good at
this), but at the opposite extreme the detection of a false relation between
reality and its interpretation can be quite a rare and refined skill - and it
is this skill, I think, which good psychotherapists have. I’m pretty sure
that this is an art which cannot be taught to those who don’t in some measure
already possess it, and I doubt very much if it can be legitimately or sensibly
made the subject of degrees and diplomas. Certainly, it cannot be made the property
of any particular profession, and it seems to be a gift which crosses all boundaries
of class and education.
However, if the art of psychotherapy is at heart radically indefinable, the psychology
to which it relates can, I believe, be more easily pinned down and elaborated
intellectually. The relationship between the two - i.e. between psychotherapy
as art and psychology as science - is not, however, a simple and direct one,
as for example between a science and its application. Psychotherapy depends crucially
on intuition and sensibility. As soon as it tries to ‘apply’ theoretical
principles or empirical rules it becomes ham-fisted and inauthentic in obvious
and embarrassing ways. But what both the ‘therapeutic’ and the ‘scientific’ understanding
of psychological distress do have in common, I suggest, is precisely a preoccupation
with the individual’s - people’s - relations with the world, in particular
the social context, in which they exist. In fact, as I’ll suggest in a
minute, the application of this kind of psychology would and should, and up to
a point does, look quite a bit different from the art of psychotherapy.
There is no doubt that in my forty-year dealings with psychology I’ve shifted
- I would say evolved - my position quite a bit, and it seems to me now that
both theoretical considerations and empirical observation - especially clinical
experience - indicate that our psychology has to be uncompromisingly environmental.
We are in every sense the products of the world into which we were born and the
only viable job for psychology is to explicate the phenomena of our experience
in the light of the influences of the environment. This is not something we’ve
yet managed to do, though, as for example with behaviourism, we’ve occasionally
got almost within shouting distance.
Nothing any longer justifies our putting ourselves beyond nature by constructing
for ourselves a set of rules, a philosophical or ethical position, which distinguishes
us from the rest of the natural world. Psychology has yet to make the Copernican
switch which topples us from the pivotal position we have tried to reserve for
ourselves as the centre of a moral and experiential universe. If we are to understand
our own experience and our own conduct we have to see that we cannot opt out
of the inexorable influences we are happy enough to countenance for everything
else around us, animate or inanimate. Certainly, being, in a sense, the authors
of our own understandings - being, that is to say, the beings in whom that understanding
is generated and by whom it is elaborated and expressed - places us in an extremely
complex and confusing situation, and it is small wonder that we end up crediting
ourselves with the creation of powers which in fact we only mediate, that we
make gods in our own image and further allocate ourselves a special relationship
with them.
But it is above all the observation over many years of people (including myself)
struggling with adversity, failing too often to achieve their own moral goals,
twisting and turning too often in vain to avoid the tragedies of their own fate,
which convinces me that we really have far, far less control over our lives than
we seem to be able to bear, most of the time, to countenance. As psychologists
- but not, I hasten to add, as ordinary citizens or in our private lives - we
need to purge our vocabulary of the words which blind us to our true status as
creatures of the environment, i.e. words like ‘will’, ‘responsibility’,
and we need also to be extremely circumspect about the use of other words which
can also be profoundly misleading - e.g., ‘choice’, ‘freedom’ (all
these words, interestingly, tend to feature quite prominently in the literature
of psychotherapy, particularly so-called ‘humanistic’ psychotherapy).
The challenge that faces psychology, it seems to me, is to be able to give an
account of human conduct and experience which is both radically materialist,
even determinist, and able to accommodate our absolute conviction of being free
agents, and by ‘accommodate’ here I mean not just explain away, but
answer satisfactorily all the questions that that conviction poses.
The success of natural science has been partly in developing the means to see
beyond and beneath the surface of things, but also in being able to persuade
doubters of the correctness of its vision. Psychology has, I think, been weak
in both these areas, but particularly in the latter. I remember in my first days
as an undergraduate being outraged at our teachers’ insistence that we
abandon the misleading promptings of our subjective vision of the world, and
even now I think I was right to resist that injunction even though in many ways
I have come to see it as correct. For what was wrong was not the precept itself
- subjective conviction frequently is very misleading - but the arguments and
so-called evidence used to support it: what we were being invited to abandon
our subjectivity for was a pathetic hotchpotch of behaviouristic observations
masquerading as ‘laws’ of nature, propounded with almost fanatical
zeal by a self-appointed orthodoxy who appeared to be according themselves almost
religious authority. This was scientism, not science, and all it succeeded in
doing was obscuring the grain of truth at its centre.
But it is true, I think, that one of the greatest obstacles to our being able
to build an accurate psychology is the almost irresistible force of our own personal
conviction in the truth of what our subjective experience appears to reveal to
us. Seeing, hearing, feeling is believing. Or so it seems. In fact, the environment
operates on us in all sorts of mysterious and invisible ways which are cut off
from our personal knowledge by time and space. Yet, of course, all those distant
and unfathomable influences end up being mediated by people and events which
impinge, just about literally, on our skin, and it is these, proximal influences,
the ones we can see, hear and feel, to which we give the credit for our condition.
And so, among other things, the explanation we give for the things people do
to us tend to stop at the people themselves, and we create a vast array of essentially
volitional concepts for what goes on in them and indeed ourselves. Therapeutic
psychologists, for example, rarely get much further than families when accounting
for the experience and behaviour of their patients, and the whole therapeutic
process depends, whether explicitly or implicitly, on the notion that freely
willed adjustment follows naturally upon insight. Voluntarism in one form or
another lurks in every corner.
But I don’t think that in truth it’s like this at all. I can’t
argue my case in detail now - perhaps I’ll spend some of my retirement
trying to elaborate arguments I’ve so far stated only very imperfectly
- but I will say in outline how things seem to me.
I don’t think we are so much the authors of our actions as their hosts,
and I don’t think our so-called ‘cognitions’ are so much causes
of our actions as a kind of commentary upon them. I don’t think we ‘decide’ to
do things so much as observe what we have done, or are about to do. Our whole
everyday language of thought and action, the concepts which not only ‘ordinary
people’ but most ‘ordinary psychologists’ as well take for
granted, are I suspect wildly misleading when it comes to giving explanations
for things.
We are not self-contained, ‘self-actualizing’ individuals, bounded
from each other by our independent intelligence and will. Insofar as we are individuals
at all, we are individual bodies, biological entities which constitute loci through
which environmental - social and physical - influences flow transitively and
intransitively. That’s to say, some (intransitive) influences stop at the
body as feelings and experiences, other (transitive) influences are mediated
by the body as conduct acting back into the environment. We are far more (though
not quite solely) the interested spectators of and commentators on these processes
than we are their originators and manipulators, and we don’t have anything
like the control over them we like to think we do.
It is as if what we think of as a person kind of explodes into being as the various
influences which structure the social world focus on each new human infant. The
infant constitutes the biological locus at which environmental influences intersect.
To understand the person we need to understand how these influences work and
where they come from, etc. Simply interrogating the individuals themselves is
unlikely to be particularly enlightening.
This kind of view has far-reaching implications which, among other things, make
it profoundly unpopular with what we might now call turn-of-the-century consumerist
capitalism. For what it does is suggest that the kind of concepts so beloved
of consumerist capitalism’s political wing - i.e. concepts such as ‘responsibility’, ‘naming
and shaming’, ‘zero tolerance’ and so on and so forth - are
as empty of validity as of substance. For what matters are not the feelings,
resolutions, pangs of conscience or assumptions of guilt which can be brought
about in individuals, but the actual features of the environment which shape
and maintain our conduct and experience. If it really does matter what the world
is like, then we have to turn our efforts away from threatening, cajoling and
therapizing individuals to actually doing something about all the polluting junk
which poisons our bodies and batters our minds at every waking moment.
In this kind of setting the job for an applied (clinical) psychologist becomes,
I would submit, rather paradoxically perhaps, not so much to do with tending
and ministering to people’s thoughts and feelings, their ‘cognitions’,
fantasies, hopes and fears, etc., but in unravelling with them the myriad ways
in which past and present environmental influences have and do serve to cause
them pain.
This actually is as an activity fairly distinct from psychotherapy, although,
because of the need to build a viable relationship with clients, there will certainly
be common elements to both. But being an ‘enviro-analyst’ is quite
a different thing from being a ‘psycho-analyst’ and offers in fact
a much wider range of application. There is, for example, no reason to assume
that analysis of environmental influences is best limited to work with individual
sufferers: by the time someone’s fallen victim to their circumstances there
may well not be a lot they can do about it in any case. In fact, there is probably
a potentially much greater role for prevention in this kind of approach than
for trying to patch things up once the damage has been done. This is of course
well recognized in community psychology.
One of the things I like most about this kind of approach, when it does come
to working directly with people, is that it removes all the mystique and superiority,
moral preciousness and general professional bullshit which can so easily taint
the role of psychotherapist. The professional relationship with the client becomes
very like that of any other provider of advice and assistance - e.g., lawyers,
architects, landscape gardeners. For what we are doing is not peering into the
darkness of people’s hearts, questioning their motives and imputing to
them secret fantasies and guilty wishes, but trying to establish as accurately
as possible the environmental influences causing them difficulty. This takes
us entirely out of the business of moral and aesthetic judgement, and requires
us only - and this is no small requirement! - to underpin our activities with
convincing evidence and sound argument.
Well, convincing evidence and sound argument: there’s been all too little
of these, I’m afraid, in what I’ve been saying this afternoon. I
could go on, and on and on, trying to justify what I’ve said, trying to
say other things, but maybe this is a good enough time to stop. And stop, in
any case, I’ve got to do pretty soon.
Thanks for listening, yet again, to stuff many of you have already heard ad nauseam
over the years. Thanks also for our support and your tolerance, those of you
who have had to put up with me in some capacity or other. Support and tolerance
which have helped in no small measure to make it possible for me to make whatever
contribution I may have made to and through my profession.
To tell you the truth, I don’t really know what I feel about retiring.
But I do know that I really like and feel at home with clinical psychologists
as a group, and nowhere of course more than here, in Nottingham, in this group.
David Smail
Nottingham, 21st April, 1998
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