Skills For Health Draft on Proposed National Occupational Standards (NOS) for Psychodynamic/Psychoanalytic Practitioners – A Response And Critique

Comments on the PADT

PADT 1
As pointed out above, the notion of performance criteria is inherently flawed. A psychoanalyst does not perform, because the notion of performance implies one is performing for someone, exactly what an analytic work will be aimed to undermine.

Point 1 states that the clinician must ‘respond sensitively to the individual’s current preoccupations and distress’. But what could be meant by ‘need to’? How can anyone determine what would be best in a very particular clinical situation in advance? If a prospective analysand expects a sensitive response, the analyst might decide that the best strategy might be to respond with great insensitivity – on the other hand an insensitive demand for analysis might be met with a very sensitive response from the clinician. Everything depends on the particularity of the individual context, and many schools of psychoanalysis see it as fundamental that the clinician responds in a way that does not match the expectation of the analysand.

Point 2 The clinician is supposed to make an assessment here of how the individual would manage without the therapy’s “imposed structure”. What does this mean? Some schools think that therapist imposed structure means the empirical meetings with the flesh and blood therapist, while others see it as a structure operative within language that may function without the presence of the therapist. The presence of the therapist is of course no guarantee of any structure.

Point 9 The clinician is supposed to ‘encourage the individual to discuss and explore their perception of and feelings about’ the therapist. Many schools of psychoanalysis in the world today contraindicate this point and hold that an encouragement by the therapist to the analysand on this point is a technical mistake in treatment.

Point 10 The clinician is supposed to ‘accept the individual’s view of you as therapist to allow particular experience of the individual self in relation to you to emerge in the session’. This is conceptually and clinically a mistake. How could you know what the individual’s view is or anything about their relation to you, as this will of course change from one moment to the next in the course of a treatment. Here, and elsewhere, in the document there is the highly dubious assumption that there is such a thing as ‘the therapist’ which remains unchanged throughout the treatment.