In the preparation period leading up to the sumbission of ideas to the HPC last autumn, this comment was made by Dr Richard Klein. It's a beautiful piece of writing: enigmatic, rhythmic, wise.
"The specular image of the mirror stage is the banal instrument that keeps us in the scene, that keeps us where we like to be, and that protects us from the world. The scene, of course, is imaginary - it is dominated by the image, and it introduces inertia into our mind.
"Politicians use it for electioneering purposes, or for moral goals. In psychoanalysis, we call this goal an ego ideal. Our political leaders embrace this ideal quite frequently - if not all the time. If you want to call a network of signifiers out of which come rules, regulations and laws - if you want to call that the symbolic, you would be following Lacan a little bit. The neo-labour politician speaks at the level of the ego ideal in order to shore up what he or she perceives to be unravelling and in order to ensure its citizens protection from all sorts of criminals.
"He promises from the point of the ideal to keep all “his people” (usually an American politician that uses this expression) safely in the scene, offering them protection from the world. For instance, Britishness is perceived to be unravelling. It has become an ego ideal that does not keep enough people in the scene anymore. We hear the signifier “British” uttered with increasing frequency and desperateness by our political leaders. It’s not only Europe that the British don’t want. The British don’t even want Britain. Freud’s famous question has never been answered. What does the woman want? Our politicians have to cope with a question that produces an even greater enigma that Freud’s: What do the British want?
"Life is difficult for a politician in this country. The ideal signifiers have weakened. Moreover, I am not too sure what the world is from which I need political protection. I think it is probably the atmosphere which is wearing out as an effect of whatever is falling out of the scene: storms, volcanoes, earthquakes, tsunamis, oceans, mountains, animal life, drains and sewers to catch what is falling out of the scene. None of this fits very well into the categories of the symbolic and the imaginary.
"But there is still one trick left to symbolise the world: we can’t have God without a plague of locusts. We can’t have the Father without real effects.
"These very politicians who do not know what the British want, now invite us to provide them with some ideas about what we want. "you tell us how we can protect everyone from the world. We are reasonable people. We will play with your ideas." this invitation is no more and no less an attempt to demonstrate to the world that our government runs on reason from the Scottish Enlightenment.
"What does the psychoanalyst want? Not all. That's what the psychoanalysts want. We must confront the government with that same enigma; the one that the woman confronts Freud with, and as it turns out, the one that the British do too. Not all."
Sunday, 1 March 2009
College of Psychoanalysts meet CE Marc Seale, Michael Guthrie and PLG chair Diane Waller
This interesting report is published on the website of the College of Psychoanalysts-uk. Click the heading to be redirected
The College of Psychoanalysts-UK meeting with HPC 27.2.08
Darian Leader and Andrew Hodgkiss met with Diane Waller, Michael Guthrie and Marc Seale.
We started by bringing up the claim made at the last PLG meeting that therapists pose a public threat, with their figure being 5%. Seale and Waller admitted that they had no hard data on this, and that their only statistics came from Witness and Fonagy, not based on any published studies, and that HPC had done no research themselves. So, we put it to them that this was anecdotal, reminding them that the Washington State discussion of therapy had insisted that claims about threatened public harm could not be based on tenuous argument or anecdotal evidence. Seale said that the "proof" was that all professions regulated by HPC showed 1.8-2% malpractice. This is the figure then to be expected from the therapies. We pointed out that this was circular and could be an artefact of the HPC framework itself. Social scientists, we suggested, could not take such an argument seriously. Seale said "I don't know what a social scientist is".
There was a discussion of the alleged threat of harmful practitioners, and we asked why, if public protection was the key variable for HPC, they were not pursuing protection of function rather than protection of title. What was the logic behind this? Seale indicated that in the place of protection of function there would be a campaign aiming at public education, presumably with the message that only HPC practitioners were to be trusted.
There followed a long discussion about healthcare and why many practitioners could not situate themselves beneath this rubric. AH contrasted his work as an NHS psychiatrist with his work as an analyst. We tried to explain how many analysts and therapists do not buy into the ideology of health, happiness and well-being or the idea of expertise. Waller could not accept this, saying that there is a shared common view of health and well-being today, different from the old medical model. We went through parts of the HPC booklet 'Standards of Conduct, Performance and Ethics', pointing out how most of them were not compatible with analytic work and many forms of therapeutic work, and Waller seemed to recognise this. Examples included clear communication to a patient, contrasted with a traditional analyst's silence, and the obtaining of prior informed consent, when in analytic work and many forms of therapy the unknown outcomes make this problematic.
We explained the position of the practitioner as object of projections, with clinical examples and emphasised the open-ended nature and unpredictability of the work. Waller felt that anyone going for 'treatment' had to know what to expect - "They have to know the likely outcome", "You wouldn't enter into a relationship without knowing in advance what was going to happen" - but then admitted soon afterwards that "we don't know what's going to happen" in a therapy and that "the patient's expectations cannot be met".
We expressed concern that in the current HPC documentation re proposed generic standards for psychotherapy, there was frequent reference to evidence-based practice. The practitioner, according to HPC, must be aware of "what is known". We questioned the conceptual basis of this appeal to a given, and Waller admitted that the multiple orientations in the field left little room for consensus. Seale added that if a complaint were brought against, say a Kleinian, there would be at least one Kleinian on the panel hearing the complaint.
We discussed at length the HPC sanitised image of the practitioner and explained why this had little to do with the recognition of human weakness and failing involved in our work. We discussed clinical examples, and there was a slight tension and disagreement between Waller and Seale. We emphasised that we do not aim at 'good personal conduct', which seemed to surprise Seale, although these arguments had often been made in prior correspondence with HPC.
Waller was open to rational argument, and would concede points, but Seale appeared unable to. There was a moment in the meeting when it seemed finally we had got through and that they could see that many people just didn't offer healthcare with set outcomes. But Seale couldn't accept this. At one point he divulged that the current complementary medicine division between state registered and voluntary registered practitioners - which was mentioned in the discussion as being a possible structure for therapists - would be destroyed in three years, when a major public advertising campaign would begin to discredit those on the voluntary register. Later in the meeting, when the possibility of a separate list of non-HPC practitioners was returned to, he said that a couple of years after HPC regulation, they would launch a media campaign to discredit them too, with the message 'Don't use these people'. We observed that this would create a lot of protest, and Seale replied - with glee - that "We can afford a better advertising agency than them". When DL took up the 'Don't use these people' at the end of the meeting, he tried to avoid the issue.
At the end of the meeting, Seale came back to the question - what details would you want changed so you will go on the register? He is really anxious just to get on with it and close the case. We asked them 'Who would you trust - someone who is willing to be prosecuted for upholding the ethics of their work or someone who seeks primarily status and credibility?'. Waller of course indicated the former, while Seale said 'I don't understand the question'. We reminded them that the very first point of the 'HPC Guidance for Occupations Considering Applying for Regulation by the HPC' is that "The occupation must cover a discrete area of activity displaying some homogeneity' and this was clearly not the case. Seale now made it clear - probably despite himself - that if a practitioner receives money from a member of the public and does not offer a predictable healthcare outcome, they just shouldn't be allowed to practise. Such practices would presumably constitute exploitation. For him, even if he could recognise the difference between orientations, he seems firmly opposed to letting the forms of non-healthcare therapy continue in modern society. So, a far stronger position than that claimed up till now publicly by HPC.
The College of Psychoanalysts-UK meeting with HPC 27.2.08
Darian Leader and Andrew Hodgkiss met with Diane Waller, Michael Guthrie and Marc Seale.
We started by bringing up the claim made at the last PLG meeting that therapists pose a public threat, with their figure being 5%. Seale and Waller admitted that they had no hard data on this, and that their only statistics came from Witness and Fonagy, not based on any published studies, and that HPC had done no research themselves. So, we put it to them that this was anecdotal, reminding them that the Washington State discussion of therapy had insisted that claims about threatened public harm could not be based on tenuous argument or anecdotal evidence. Seale said that the "proof" was that all professions regulated by HPC showed 1.8-2% malpractice. This is the figure then to be expected from the therapies. We pointed out that this was circular and could be an artefact of the HPC framework itself. Social scientists, we suggested, could not take such an argument seriously. Seale said "I don't know what a social scientist is".
There was a discussion of the alleged threat of harmful practitioners, and we asked why, if public protection was the key variable for HPC, they were not pursuing protection of function rather than protection of title. What was the logic behind this? Seale indicated that in the place of protection of function there would be a campaign aiming at public education, presumably with the message that only HPC practitioners were to be trusted.
There followed a long discussion about healthcare and why many practitioners could not situate themselves beneath this rubric. AH contrasted his work as an NHS psychiatrist with his work as an analyst. We tried to explain how many analysts and therapists do not buy into the ideology of health, happiness and well-being or the idea of expertise. Waller could not accept this, saying that there is a shared common view of health and well-being today, different from the old medical model. We went through parts of the HPC booklet 'Standards of Conduct, Performance and Ethics', pointing out how most of them were not compatible with analytic work and many forms of therapeutic work, and Waller seemed to recognise this. Examples included clear communication to a patient, contrasted with a traditional analyst's silence, and the obtaining of prior informed consent, when in analytic work and many forms of therapy the unknown outcomes make this problematic.
We explained the position of the practitioner as object of projections, with clinical examples and emphasised the open-ended nature and unpredictability of the work. Waller felt that anyone going for 'treatment' had to know what to expect - "They have to know the likely outcome", "You wouldn't enter into a relationship without knowing in advance what was going to happen" - but then admitted soon afterwards that "we don't know what's going to happen" in a therapy and that "the patient's expectations cannot be met".
We expressed concern that in the current HPC documentation re proposed generic standards for psychotherapy, there was frequent reference to evidence-based practice. The practitioner, according to HPC, must be aware of "what is known". We questioned the conceptual basis of this appeal to a given, and Waller admitted that the multiple orientations in the field left little room for consensus. Seale added that if a complaint were brought against, say a Kleinian, there would be at least one Kleinian on the panel hearing the complaint.
We discussed at length the HPC sanitised image of the practitioner and explained why this had little to do with the recognition of human weakness and failing involved in our work. We discussed clinical examples, and there was a slight tension and disagreement between Waller and Seale. We emphasised that we do not aim at 'good personal conduct', which seemed to surprise Seale, although these arguments had often been made in prior correspondence with HPC.
Waller was open to rational argument, and would concede points, but Seale appeared unable to. There was a moment in the meeting when it seemed finally we had got through and that they could see that many people just didn't offer healthcare with set outcomes. But Seale couldn't accept this. At one point he divulged that the current complementary medicine division between state registered and voluntary registered practitioners - which was mentioned in the discussion as being a possible structure for therapists - would be destroyed in three years, when a major public advertising campaign would begin to discredit those on the voluntary register. Later in the meeting, when the possibility of a separate list of non-HPC practitioners was returned to, he said that a couple of years after HPC regulation, they would launch a media campaign to discredit them too, with the message 'Don't use these people'. We observed that this would create a lot of protest, and Seale replied - with glee - that "We can afford a better advertising agency than them". When DL took up the 'Don't use these people' at the end of the meeting, he tried to avoid the issue.
At the end of the meeting, Seale came back to the question - what details would you want changed so you will go on the register? He is really anxious just to get on with it and close the case. We asked them 'Who would you trust - someone who is willing to be prosecuted for upholding the ethics of their work or someone who seeks primarily status and credibility?'. Waller of course indicated the former, while Seale said 'I don't understand the question'. We reminded them that the very first point of the 'HPC Guidance for Occupations Considering Applying for Regulation by the HPC' is that "The occupation must cover a discrete area of activity displaying some homogeneity' and this was clearly not the case. Seale now made it clear - probably despite himself - that if a practitioner receives money from a member of the public and does not offer a predictable healthcare outcome, they just shouldn't be allowed to practise. Such practices would presumably constitute exploitation. For him, even if he could recognise the difference between orientations, he seems firmly opposed to letting the forms of non-healthcare therapy continue in modern society. So, a far stronger position than that claimed up till now publicly by HPC.
Philip Pullman and Fergal Sharkey at the Convention on Modern Liberty
Yesterday was the Convention on Modern Liberty - an extraordinary thing that happened in many cities in the UK and that brought together a very mixed bag of Brits. Lucky enough to live in London I was able to get a seat to see Philip Pullman deliver his 10 minutes worth of political poetry. He spoke from the heart - literally a voice of courage, speaking of courage: to act kindly, with good judgement, thinking of the long term, and not afraid of headlines in the Daily Mail. He said many memorable things:
"Joy does not flourish in the garden of anxiety."
"Acquiring modesty would give a proper sense of position in this world and remove the self-importance of politicians who think they are fighting an extensional war to defend western civilisation, when they are actually throwing their weight about behind the bike shed like playground bullies."
"When there came a threat from external nations a courageous nation would take a clear look at the danger and take realistic steps to avert it not take up a machine gun to defend itself against a wasp."
and most delightful of all:
"A modest Kingdom would have to think for a moment whether or not it was a republic, because its Royal family would be small and its members would be allowed to spend most their time in interesting careers as well as being Royal, their love affairs would remain their own business and people would always be glad to see them cycling past."
At the end of the day a small panel of writers and artists addressed those remaining. Fergal Sharkey was amongst the speakers, he is now Chief Exec of UK Music. He read out a clause from the Licensing Act 2003 which requires venues to fill in form 696 (or 57, or something) which insists on a risk assessment for any forthcoming performance of belly dancing, or live music etc. Two things stuck in my mind: first, the form required that names and addresses and other personal details of all of the performers be submitted to authorities two weeks in advance of the act. The second thing is that this law was passed into the practice of the majority of London Borough Councils seemingly without close scrutiny. Sharkey is now writing to various Councils asking them what on earth they think they are doing. His letters so far have received no reply.
I thought that his work exemplified the kind of courage Pullman calls for, once adored as a popular singer, he doesn't shirk from doing mundane work - reading through pages of legal documents, and following up the consequences and their preconditions. I think this way turns blunt acts of power into situated stories and re-introduces joy into a garden that might otherwise be overrun by anxiety. Inspiration, really.
"Joy does not flourish in the garden of anxiety."
"Acquiring modesty would give a proper sense of position in this world and remove the self-importance of politicians who think they are fighting an extensional war to defend western civilisation, when they are actually throwing their weight about behind the bike shed like playground bullies."
"When there came a threat from external nations a courageous nation would take a clear look at the danger and take realistic steps to avert it not take up a machine gun to defend itself against a wasp."
and most delightful of all:
"A modest Kingdom would have to think for a moment whether or not it was a republic, because its Royal family would be small and its members would be allowed to spend most their time in interesting careers as well as being Royal, their love affairs would remain their own business and people would always be glad to see them cycling past."
At the end of the day a small panel of writers and artists addressed those remaining. Fergal Sharkey was amongst the speakers, he is now Chief Exec of UK Music. He read out a clause from the Licensing Act 2003 which requires venues to fill in form 696 (or 57, or something) which insists on a risk assessment for any forthcoming performance of belly dancing, or live music etc. Two things stuck in my mind: first, the form required that names and addresses and other personal details of all of the performers be submitted to authorities two weeks in advance of the act. The second thing is that this law was passed into the practice of the majority of London Borough Councils seemingly without close scrutiny. Sharkey is now writing to various Councils asking them what on earth they think they are doing. His letters so far have received no reply.
I thought that his work exemplified the kind of courage Pullman calls for, once adored as a popular singer, he doesn't shirk from doing mundane work - reading through pages of legal documents, and following up the consequences and their preconditions. I think this way turns blunt acts of power into situated stories and re-introduces joy into a garden that might otherwise be overrun by anxiety. Inspiration, really.
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