Deconstructing CBT

As Cognitive Behavioural Therapy is the dominant force in today’s therapy market place, it is important to unknit what it is. This – of course – can be difficult to do when signifiers such as ‘evidence-based’ and ‘cure’ are banded around as if they were unproblematic constructs.

Jay Watts has written and lectured on how CBT does not exist except as a political convenience.

Del Loewenthal has co-edited a book Against and for CBT: Towards a Constructive Dialogue? with colleague Richard House.

Here are some videos from conferences challenging CBT which may be of interest.

There are some fine practitioners working under the mantle of CBT, of course. Many of these share CPN’s beliefs that clients do not have the time and space to talk freely in therapy today, and feel increasingly impotent in services which privilege meeting targets above ethical practice.

Connect

Please fill out this form if you wish to connect with the Critical Psychotherapy Network. In so doing, you will be helping to build communities that support free speech in and about the consulting room. We welcome comments on how to progress the Society, and blogs or vlogs on issues around critical psychotherapy. We also encourage you to consider joining a CPSC or Local Group.

Welcome

It is becoming increasingly difficult to find a place to speak freely. Psychotherapists, psychoanalysts and counsellors report that it is less and less possible to question organisational practice, fearful of overt or covert punishment. Academics in our universities fear for their jobs if they speak out. Most importantly, the therapeutic space itself has become subject to various insistences – what is sayable, what is hearable, what must be reported, what technique must look like. Neoliberalism, the rise in the audit culture, and the overregulation of therapy challenges such freedoms. So what do we do? We have, it seems, a few options:

  1. Do nothing.
  2. Try and change the way in which NICE goes about producing its recommendations, including its language, challenge the composition of Guideline Development Groups and the use of Randomized Controlled Trials as a meaningful way of assessing psychotherapy.
  3. Take the advice of people who suggest we do not fight NICE and RCTs but attempt to ape CBT’s success with manualisation, and so on.
  4. Help stimulate very different potential cultural changes and critically develop our own work to help those who want to explore personal meaning; and for research, stick to case studies as well as collaborations and learnings from those outside our field.

We argue the fourth option is the only real one for the therapy professions.  We have, surely, a duty to preserve spaces where those suffering can come to talk freely. To date, we have published a book Critical Psychotherapy, Psychoanalysis and Counselling and held our inaugural conference at the Freud Museum. The book and conference developed a critical psychotherapy manifesto and action plan. We have come together to form a Unit to build communities that will fight to preserve and build psychotherapy as a critical, open, sometimes subversive space. We believe the importance of a practice oriented to free speech trumps allegiance to any particular therapeutic modality, and welcome anyone with similar interests to come and join us. Will you?

Professor Del Loewenthal, Co-Chair, The Society for Critical Psychotherapy

. Del Athens 2015

Trainings

Fewer trainings focus on helping trainees develop skills to hear themselves and others. Network founders are currently involved in trainings in psychotherapy, psychoanalysis, counselling psychology and clinical psychology with the aim of creating space for critical thinking.

The Network is also developing a Critical Psychotherapy Training programme. Del Loewenthal currently runs the Critical Existential-Analytic Psychotherapy and Counselling programme at Roehampton which may be of interest to some readers.

We welcome blog post submissions on critical thinking within therapy trainings, and ideas for how to develop more creative forms of transmission.

Inaugural conference audio

We held a conference to mark the launch of the book at the Freud Museum in June, 2015.

You can listen to the audio of the preview evening here The Many Faces of ‘Critical Psychotherapy’ featuring Professors Del Loewenthal, Michael Rustin and Andrew Samuels.

The audio of the conference is available in four parts.

1. INTRODUCTION

Do we need a Critical Psychotherapy? with Professor Del Loewenthal.

2. WHAT CAN WE LEARN FROM CRITICAL PSYCHOLOGY AND CRITICAL PSYCHIATRY

Toward critical psychotherapy and counselling: what can we learn from critical psychology (and political economy)? With Professor Ian Parker.

The Medical Model: What is it, where did it come from and how long has it got? with Dr Hugh Middelton

and a response from Dr David Morgan.

3. EXTERNAL CRITIQUES

When Love is Not All We Want: Queers, Singles and the Therapeutic Cult of Relationality with Dr Adrian Cocking

Critical theory and psychotherapy with Dr Anastasios Gaitanidis

and a response from Dr Julie Walsh

4. USER AND EDUCATORS PERSPECTIVES

Personal versus medical meanings in breakdown, treatment and recovery from ‘schizophrenia’ with Tom Cotton and Professor Del Loewenthal

Systemic means to subversive ends: maintaining the therapeutic space as a unique encounter with Dr Jay Watts

We welcome your feedback on the conference, whether you attended or have listened to the audios.

We are running a Dialectics of Critical Psychotherapy conference in 2015/16.

The Book

The Critical Psychotherapy Network arose as a consequence of a book – edited by Del – which bought a number of critical practitioners together. For those of you who are interested, the book is called Critical Psychotherapy, Psychoanalysis and Counselling. It consists of the following chapters.

PART I: INTRODUCTION
1. Talking Therapies, Culture, the State and Neo-liberalism: Is There a Need for Critical Psychotherapy, Psychoanalysis and Counselling?; Del Loewenthal

PART II: WHAT CAN WE LEARN FROM CRITICAL PSYCHIATRY AND CRITICAL PSYCHOLOGY?
2. The Medical Model: What Is It, Where Did It Come from and How Long Has It Got?; Hugh Middleton
3. Toward Critical Psychotherapy and Counselling: What Can We Learn from Critical Psychology (and Political Economy)?; Ian Parker
4. The Neurobiological Turn in Therapeutic Treatment: Salvation or Devastation?; Kenneth J. Gergen

PART III: USERS’ PERSPECTIVES
5. Personal Versus Medical Meanings in Breakdown, Treatment and Recovery from ‘Schizophrenia’; Tom Cotton and Del Loewenthal

PART IV: CRITIQUES COMING MORE FROM OUTSIDE
6. Critical Theory and Psychotherapy; Anastasios Gaitanidis
7. When Love Is Not All We Want: Queers, Singles and the Therapeutic Cult of Relationality; Mari Ruti and Adrian Cocking
8. Relating to People as revolutionaries; Lois Holzman
9. Work in Contemporary Capitalism; Michael Rustin

PART V: CRITIQUES COMING MORE FROM INSIDE
10. Everything You Always Wanted to Know About Therapy (but Were Afraid to Ask): Fragments of a Critical Psychotherapy; Andrew Samuels
11. Critical Priorities for the Psychotherapy and Counselling Community; Colin Feltham
12. The Deleuzian Project; Chris Oakley
13. Psychoanalysis and the Event of Resistance; Steven Groarke
14. Psychology, Psychotherapy – Coming to Our Senses?; Paul Moloney

PART VI: CRITIQUES OF TRAINING AND LEARNING
15. Contesting the Curriculum: Counsellor Education in a Postmodern and Medicalising Era; Tom Strong, Karen H. Ross, Konstantinos Chondros and Monica Sesma-Vazquez
16. Systemic Means to Subversive Ends: Maintaining the Therapeutic Space as a Unique Encounter; Jay Watts

PART VII: IS THERE AN UNFORTUNATE NEED FOR CRITICAL PSYCHOTHERAPY, PSCYHOANALYSIS AND COUNSELLING?
17. Psychotherapy, Psychoanalysis and Counselling for Oppressors and Oppressed: Sex, Violence and Ideology in Practice?; Del Loewenthal

Do send us feedback on the book if you so wish, either by email or commenting below. We think it’s an important start – but there is more to be done.

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The action plan

There are a number of actions that are central to the Network. We think it is crucial to:

  • We believe clients need the option to explore personal meaning the opportunity for which is increasingly being lost .
  • ‘The human soul comes before science and techology’. We must challenge ideologies that get in the way of this truth.
  • We think it crucial to remember that we are all capable of good and evil.
  • We must have therapeutic spaces available where we can explore how we constrict ourselves and others through our sexuality and violence,  morality and economic systems.
  • People may involve themselves in order to forget their troubles, but both psychotherapists and clients can manipulate this in a degenerate way.
  • We need multiple stories of suffering otherwise our minds and actions are colonised.
  • We must question received wisdoms of what a good therapy outcome looks like
  • We must attend to power inequalities, and disobey normal rules and conventions. To influence, we must talk in ways people understand not rarified jargon.
  • We believe that increased state regulation may give new capacities for resistance, and that the development of new talking spaces need not be called therapy.
  • We believe talking therapists can be as much the problem than the solution.
  • Politics can get replaced by scepticism and capitalism by modernity.

We are too caught up with individualism, pseudoscience and the language of medicine and clinical psychology. We need to refind and develop our own language.

These actions points are adapted from Del’s chapter in Critical Psychotherapy, Psychoanalysis and Counselling but are very much a work in progress. Please add your comments below, and help us develop.