9 ..9
There is always the potential for predatory or deluded practitioners to cause harm. Psychotherapy is not always helpful. It can sometimes be useless, or worse. This danger is not alleviated by framing psychotherapy as a ‘health care profession’. Of greater importance, it seems to me, is to nurture within the novice practitioner the ethical core – of respect, care, thought, sensitivity to boundaries, and refraining from presuming to know.
References
Beck, A.T. (1976) Cognitive Therapy and the Emotional Disorders, Penguin 1996
Casement, P. (1985) Learning from the Patient, Routledge London
Eysenck, H. (1952) The effects of psychotherapy: an evaluation, in Journal of Consulting Psychology, 16. 319-324
Freud, S. (1926) The question of lay analysis, in Standard Edition of the Complete Psychological Works of Sigmund Freud. XX, Hogarth London
Hover-Kramer, D. (2006) Creating Right Relationships. A Practical Guide to Ethics in Energy Therapies, Behavioral Health Consultants, Cave Junction OR
Mollon, P. (2009) The NICE guidelines are misleading, unscientific, and potentially impede good psychological care and help, in Psychodynamic Practice, 15. [1] February. 9-24
Ross, C., & Pam, A. (1996) Pseudoscience in Biological Psychiatry, Wiley Chichester.
[1] See Beck’s account in his 1976 book Cognitive Therapy and the Emotional Disorders, pages 29-35, in which he describes the moment when he became aware of a more hidden stream of thought behind the client’s reported free-associations. [Penguin Edition 1991]
[2] Ross and Pam, in their book Pseudoscience in Biological Psychiatry [Wiley 1995] comment:
“Many women who exhibit intense emotions (especially anger), mistrust authority, and have difficulties with relationships, receive the diagnosis borderline personality disorder, and a great deal of medication that doesn’t help, when their symptoms are caused by childhood trauma. These women become more powerless and silent as a reaction to invalidation, blaming, and the victimization they encounter within biological psychiatry.” P 223.
The medical model attitude often remains the same when a seemingly psychological perspective is offered. A ‘prognosis’ is made and psychological therapy of some NICE-approved variety is ‘prescribed’.
[3] NICE purports to offer clinical guidelines concerning: “The appropriate treatment and care of people with specific diseases and conditions within the NHS”. This somewhat hidden statement is found on the ‘What we do’ section of the NICE website www.nice.org.uk, where it explains their three ‘centres of excellence’. The Centre for Clinical Practice produces the guidelines: “The Centre for Clinical Practice develops clinical guidelines. These are recommendations, based on the best available evidence, on the appropriate treatment and care of people with specific diseases and conditions”.