The third crucial issue is of transference. All psychoanalytically inspired psychotherapies recognise that therapy is based on a mobilisation of trains of thought and feelings – usually established in infancy and childhood – onto the clinician. Although different therapies have different views on how or whether transference should be interpreted, there is general agreement that the landscape of psychoanalytically inspired therapy is entirely dependent on the existence of transference. This means that the patient’s relation with the therapist may involve thoughts and feelings which will very often be negative: the therapist may be seen as abusive, exploitative, unjust, etc. The whole range of negative human qualities may all become situated in the transferential space.
It is thus crucial that any considerations of the behaviour of the clinician take transference seriously: there is no neutral space outside transference within the therapy itself and there is a very great risk that regulatory bodies ill-equipped to grasp this will try to incarnate this supposedly neutral and objective standpoint from which transference can be evaluated. This is of course different from the clear cases of sexual or financial exploitation that are already codified against in the codes of ethics and practice of all psychotherapy trainings.
The above three issues are nowhere dealt with in the HPC literature to date despite their centrality to the whole question of potential regulation. There are also a number of other problems in the December document. In the section headed ‘Maximising the success of the process to regulate an aspirant group’, we read that “one measure of the success of the process to bring an aspirant group into statutory regulation is the percentage of individuals who either join the register when it opens, or are eligible to join the register once they have completed their programme of education and training”. However, as we understand it, individuals who choose not to join the register will be prohibited by law from practising. Hence it is a circular argument to claim that the success of the legislation can be gauged by its uptake. This is rather like saying that the success of using red as the colour of traffic lights to indicate that vehicles should stop can be gauged by the number of vehicles that go through red lights. This will obviously be a minority.
We also note in the same section that although “there are many who will welcome the introduction of statutory regulation, there might be a small but vocal minority of individuals and organisations who may want to avoid statutory regulation for a variety of reasons”. There follows a list of six reasons and one wonders from where the authors of the document have derived them. They emphasise non-constructive reasons rather than the ethical ones that have so far been the main focus of those opposed to the state-regulation model developed up until now. Regarding these issues, it is surely little more than rhetoric to qualify any voices of dissent in advance as ‘a small but vocal minority’ before the process has even started. The list of reasons that follow then suggest that this ‘minority’ would contain those who disagree because they are ‘unable to meet competence standards’, or ‘ethical standards’ or are ‘reluctant to pay the registration fee’ etc. Since these reasons are clearly poor ones they suggest that dissent is not grounded on serious objections but rather is simply an effort to safeguard incompetence or unethical practice or one’s financial position. The idea here is that the basic problem involves suspect practitioners and that hence the field needs to be cleaned up. This view no doubt contrasts with one which examines the actual nature and practice of psychotherapy itself and then derives its arguments from that. Such a perspective would have the advantage of appealing less to gossip and contingency.