By Beatrice Popescu and Andreea Enache
Our interviewee is Yvonne Bates, a humanistic counsellor/ therapist with The Alexander Group. She co-authored with Richard House and published “Ethically Challenged Professions: Enabling innovation and diversity in psychotherapy and counselling”, an anthology assembling 30 essays, most of them by prominent international figures in the field, which both challenge a number of psychotherapy and counselling’s most inhibiting, taken-for-granted assumptions, and offer cutting-edge visions and examples of the form and substance of an ethically mature, post-professionalized therapy practice.
She is active in the politics of psychotherapy and counselling in the UK, being committed to the development of an inclusive and collaborative therapeutic community. Yvonne is keen to challenge the myth of the therapist as expert and to encourage theorists, practitioners and policy makers to work in genuine partnership with clients to radically revise therapy in light of the challenges put forward by those clients.
Yvonne is also co-editor of ipnosis , a journal for freethinking practitioners ( www.ipnosis.com ), which is the first to offer a dedicated section for clients’ views and which has enjoyed tremendous popularity since its launch back in 2001.
EJOP: Yvonne, first of all we would want to thank you for offering us an interview. Before jumping to the controversial issues of psychotherapy politics, we would like to know where did your love for psychotherapy/counselling stem from?
Yvonne Bates: Thank you for asking me – fame at last! I had enjoyed a successful career in IT, but had become frustrated at the meaninglessness of it all, and wanted to do something completely different. I was interested in sport psychology and started a part-time counselling course whilst doing my psychology degree, but in so doing I became fascinated by humanistic therapy and basically got side-tracked.
EJOP: Almost all professionals developing a successful career in one field or another have been influenced in their growth by someone they took as a model. Did you have any mentors?
Yvonne Bates: I don’t think there is anyone whom I have considered a “mentor”. I think I have been influenced by particular books and particular individuals along the way; Irvin Yalom’s “Existential Psychotherapy” probably touched me both personally and professionally as much as any other book, even though I don’t consider myself existential in orientation. On reflection, I’m probably lucky that I don’t see anyone as a great mentor, because it suggests that my therapy education has been conducted by facilitators who have resisted the urge to be a “guru”, and have instead encouraged me to find my own voice – the hallmark of person-centeredness!
In recent years, I must say I have been most influenced by client writers such as Anna Sands, Rosie Alexander, Marie Hellewell and Natalie Simpson, who have raised such brave and powerful critiques of therapy and really forced me to re-evaluate everything I took for granted about the intrinsic goodness of the endeavour. Their work is the most important in the field, I think.
EJOP: What are the main critiques your clients have expressed toward therapy, its principles and practices, and how do you usually approach them?
Yvonne Bates: Both clients in my own practice and client writers such as those I mentioned have raised so many questions about the nature of therapy that it is impossible to do justice to them here. But they include issues such as the dependency that clients can feel towards their therapist – is it sufficiently understood? Are clients sufficiently warned about its possibility at the outset of therapy? Do therapists do enough to discourage it? Is it right that some therapists encourage it? The same questions also apply to transference, of course (even where the therapist is not psychodynamic in orientation).
Clients are asking what evidence there is to support the basic assumption made by therapists that catharsis is beneficial – they argue that there are times when it can be quite destructive. They ask if anyone really understands in what circumstances and for which clients certain emotions should be elicited, and what can be done to repair damage when things “go wrong”.
Another common area of concern raised by clients is whether the unusual nature of the therapeutic relationship and discourse can distort the client’s reality, and cause him to lose a sense of normality. Clients’ world views certainly are shaken up and completely deconstructed sometimes, and client writers are concerned that in many cases, this can actually be detrimental to mental health rather than restorative. Indeed, another issue is that therapy may be pathologising – the client’s role is to be inadequate, and this may actually create a concomitant belief or behaviour pattern of inadequacy.
These are just one or two of many, many examples. I am currently editing a book for Palgrave Macmillan, entitled ” Shouldn’t I be Feeling Better by Now: Client Views of Therapy ” which is due to be published later this year, and which assembles a number of wonderfully insightful, thorough and challenging critiques from clients all over the western world.
As for how I usually approach these issues, I have modified my own way of working to try to reduce the dangers that are being described. For example, in the past I might have encouraged a client to express her anger, with utter and devout conviction that it would be in her best interests to do so. Now, I am much more reticent about such things. Funnily enough, so many clients these days are “therapy literate” that they will say, for example, “I suppose I should be getting this anger out so I can move on”, and I might now challenge it, saying something like “the therapy world does assume that it would be beneficial, but we don’t know that do we? Do you feel, instinctively, that it will help to do that?” One could call it an increase in “metatherapy” – that is, an ongoing discussion with the client, sometimes in much detail, about how we should construct the next part of the therapy, before we actually go ahead and do the coalface work itself, if that makes sense.
The solution to some of these issues, though, goes beyond just modifying my practice in such ways. I find that nowadays, I constantly ask myself whether practice as a therapist is and/or can be consistent with my personal morality and ethics. Since I am still practising, the answer to date speaks for itself, but this is an ongoing process for me, and without wishing to sound too self-congratulatory, I believe it is a healthy self-examination with which all therapists should engage.
EJOP: We know you are trained in person-centred therapy, but gradually came to embrace other views too, and currently you successfully practice an integrative and collaborative approach. Could you please explain to our readers what this approach implies?
Yvonne Bates: Well, frankly I’m not sure whether my approach, when I really analyse it, is really anything other than a person-centred approach. I try to follow the client in how the relationship is constructed, and what kind of input I offer. I try to learn about different theories and approaches, but not so that I can apply them to a particular client in a particular situation, but rather so that, within a person-centred philosophy, I can offer an educated view of what they might comprise to a client who wishes to know such things. I believe it is my duty to know as much as I can about the world of psychotherapeutic theories, psychology in general, sociology, philosophy, politics and anything else that might be relevant to personal growth. But I think with such education must come a healthy questioning/scepticism of all such theories, so that I don’t become too evangelical or directive about any of them.
EJOP: You have already engaged in several break-through projects. How did your life change since you launched ipnosis which is quite an audacious and innovative journal?
Yvonne Bates: ipnosis has certainly been a wonderful addition to my life. It brings me into contact with all sorts of people involved in the therapy world, and in particular with client writers, whose wisdom has influenced me beyond measure, as I mentioned above. It also gives me the opportunity to poke fun at the therapy world, for instance, through Caring Carol the Cartoon Counsellor. This is a wonderful way of venting my frustrations and anger at some of the worst excesses of my frequently arrogant and self-indulgent profession!
EJOP: You present ipnosis as a freethinking practitioners’ journal. What sets ipnosis apart in the vast field of psychotherapy periodicals?
Yvonne Bates: We want the reader to engage with ipnosis not just intellectually, but emotionally, too. If she feels angry at one moment, tearful the next, thoughtful the next, then finds herself laughing, and, if she is a therapist, feels her professional world has been rattled and shaken a little, then ipnosis has reached its goal.
Because ipnosis is not affiliated to any professional body, it is only bought by people – it is not simply received as a result of being a member of something. It therefore has a fairly small but highly motivated, highly engaged readership, and tends to attract really powerful and challenging perspectives from writers. It is therefore a huge learning resource, and really forces the reader to question everything and to “think outside the box”. Nothing is sacred!
EJOP: Considering that academic debate also involves criticizing other professionals’ views, has it become difficult to publish critical studies in Britain ? Are the academics and well-established professionals in the field of therapy sensitive to critics?
Yvonne Bates: My personal view is that they are extremely sensitive to criticism, and that we are in danger of allowing academia to have a stranglehold over the entire therapeutic discourse. Academia invents its own rules about how arguments can be put forward, and then uses those rules to reject arguments that come from outside it. So there is a stultifying nepotism about the academic world’s approach to therapy which, I feel, does not sit at all comfortably with humanistic principles. In fact one might argue that there is an inherent paradox in the very notion of academic humanism in its current form.
This is something we try to challenge rigorously in ipnosis . We are committed to publishing work irrespective of its academic status. We believe that this inclusivity is essential to the wellbeing of the field.
EJOP: In her article “Psychotherapy: philosophy, not medicine”, Judy Tame argues that “any mentally sharp person with empathy, people with skills plus a little skill training and, above all, a degree from the University of Life” can do counselling and that most of the practitioners worldwide pretend doing therapy while they actually perform consultancy work. How would you formulate the difference between counselling and therapy?
Yvonne Bates: I don’t profess to know the difference, nor indeed whether there is any difference, between counselling and psychotherapy. There are so many discussions that I’ve had on therapy- and philosophy-related subjects that become meaningless when the discussers realise that it just boils down to our individual interpretations of semantics. And I think the counselling vs. psychotherapy issue is definitely one of those – everyone has their own definition of each term, so the answer is different for every person.
EJOP: The DSM is viewed by some of the therapists worldwide (even by some of your Romanian colleagues) as a rather hazardous tool, “guilty” for labelling the client and reducing his/her suffering to a category. In your practice, do you use classic diagnostic methods?
Yvonne Bates: I share the unease you have described about such diagnostic tools. I try to meet every person as a person, and build a relationship with them. I certainly do not ascribe diagnostic labels about their behaviour or personality; if anything, I work to challenge labels which they may use about themselves.
EJOP: In recent years some training schools recognizing the narrowness of specific therapies have moved to delivering a more integrative training, looking to offer a more flexible and comprehensive therapy training. How do you think this will affect the future of psychotherapy training?
Yvonne Bates: There is of course a value in educating ourselves about the different theories as I discussed above. However I also accept the argument that there is a danger of becoming “a Jack of all trades, and a master of none”. The key word in your question is “flexibility”. A good training programme should be flexible enough to support students as they follow their own path. For some students, this might mean quite a narrow specialisation, and for others, a more eclectic approach. Both have their place, I think.
EJOP: In the process of accreditation, a trainee therapist is required to perform a minimum hours of supervised therapy before getting the accreditation. It is quite difficult for inexperienced students to get the clients they need with whom they can practice what they have learned if they are not involved in a charity or voluntary organisation. Did you come across this issue as a trainee or trainer?
Yvonne Bates: Oh yes, I have come across it a lot as a course facilitator. It’s a far from perfect situation. Many students in the UK get placements with general practitioners/primary health care establishments. This has become quite a political issue, as there is an argument that too many primary health care practices exploit this to provide counselling services at little or no cost to themselves, and to “dump” a time-consuming patient on someone else rather than listen to him themselves. It can also be seen as endangering the welfare of the patients by assigning them to counsellors/therapists who are still learning the trade, and who are perhaps more likely to make mistakes.
EJOP: Do you see any solution to this problem that appears to be much of a dead end, at least at first look?
Yvonne Bates: Well, for the healthcare providers the solution is simple – more Government funding! But for the trainees looking for placements, there’s no easy answer. I sometimes wonder why students cannot be clients for their classmates (in reality, I mean, not role playing). I appreciate that this is not without its problems, but it is a controlled, contained and self-perpetuating environment, and it does mean students will spend more time in the client role, which is the best way to learn, by and large.
EJOP: We know you encourage clients to express their own views during the therapeutic process, you were one of the people who actually pioneered the idea; ipnosis even has a section especially dedicated to client’s opinions. Is this part of the so-called re-ensoulling of the therapy and wh at is its immediate impact on the therapeutic process?
Yvonne Bates: Whilst it is very flattering to be credited with pioneering this idea, I must say that good therapists have been encouraging client feedback since before I was even born! I think the main need for pioneering work is where clients raise concerns about the very nature or taken-for-granted assumptions of therapy, at a political level. Clients who have been brave enough to put such concerns in books and articles, or in media discussions, tend to have been met with very defensive attitudes by therapy writers and representatives of professional bodies. They are sometimes just ignored. Sometimes they are deconstructed and inappropriately psychoanalysed. It is easy to say that clients don’t really understand the reasons why therapists behave in certain ways because of a lack of theoretical knowledge, and also to say that they are playing out transferential issues with their therapist or the therapy community as a whole. These are convenient ways to avoid facing the very real and very cogent issues that they bring. In getting to know the client authors of Shouldn’t I Be Feeling Better By Now (see above), I have been consistently impressed with their considered and constructive reasoning, powerful arguments and indeed their understanding of therapeutic theories (many of them have taught themselves as much, if not more, than the average therapist). We must start by respecting these voices, and further, to recognise our own defensiveness and respond to the feedback as a precious gift.
EJOP: The therapy field in UK is now going through a reconstruction phase. Do you think there will be immediate benefits of this reform? Who will benefit from this process, the therapist or the client?
Yvonne Bates: If by this you mean the move towards statutory regulation, then I think the only people who are likely to benefit are people in positions of power within the professional bodies. I certainly don’t think statutory regulation would benefit clients – quite the opposite. I have written at length about the different reasons for this (see for example, my chapter “Still Whingeing” in the aforementioned book “Ethically Challenged Professions” (PCCS Books)).
However, I also doubt whether statutory regulation will ever come about anyway. There are so many diverse opinions and internecine wrangles within and between the professional bodies that sufficient consensus seems unlikely. And despite what some of our larger professional bodies would have us believe, the Government does not seem terribly interested in pushing such legislation through – the initiative seems to be coming from within those professional bodies.
EJOP: What are the advantages and disadvantages of being an independent practitioner?
Yvonne Bates: At the risk of sounding like a politician, I’d first like to answer a slightly different question, which is, “what are the advantages and disadvantages of being an independent person?” Independence and dependence are concepts which I strive to balance in my life. Independence has come to be seen as something of a holy grail in our culture. If someone is described as “independent”, this is seen as a compliment, whereas if someone is described as “dependent” this is seen as an insult. In reality, I feel the two should be value-free, and both accepted as part and parcel of what it means to be human. It is a personal struggle for me to allow myself to be more dependent upon others, as I have been encouraged throughout my life to be independent, and am only now coming to understand the limitations of this. Humans are social animals, and I subscribe to the view that the over-emphasis on independence is undermining our ability to cooperate, sustain community and care for each other. I would therefore apply the same answer to the question of being an independent practitioner – I must also accept my limitations as an individual and allow myself to also be dependent upon support, compromise and sharing in my practice.
EJOP: W hat do you see happening in therapy as we move into the 21st century?
Yvonne Bates: If I allow myself to be optimistic, then I would see most of therapy as evolving into a social skill that everyone develops, thereby taking much of it out of the professional arena. There will always be a place for some sort of clinical psychological practice for people whose needs are unusual. But for the mainstream, I believe that the consumerist, individualist society that leaves people feeling alone, empty and stressed cannot continue for much longer before there is a backlash. We need to learn to listen to each other again, prioritise friendships, family and concern for others generally, and encourage empathy, genuineness and non-judgemental regard in everyday life. The fact that such skills are commodified and professionalized to the extent that they are is astounding, and I feel angry that society is thereby being robbed of something as fundamental to its survival as water and oxygen.
To put it another way, I sometimes see a lot of therapy as people trying to squeeze more and more resilience out of themselves to survive in the cold world around them, and that we can only do so much of this before we are forced to collectively come together to change that world into a better, more loving one where we can all flourish.
Yvonne Bates, March 2005.