The Mystery of FTP. Andrew Marr, Archbishop of Canterbury, Philip Pullman, Mona Sidiqqui and David Baddiel help us to think about the HPC

The big idea written into the circuitry of the HPC is that professional organisations have vested interests which render them unfit to be given statutory power and to conduct their own regulation. Only an organisation free from vested interests is capable of dealing objectively with regulation says the One with the big idea.

This assumes that there are other kinds of organisations that do not have vested interests. Thus a central and longstanding problem is dismissed at a stroke. This blind spot at the heart of the HPC is identical to that which gives prejudice its energy. It gathers together a set of people and separates them from other people through the application of a negative characteristic. Written into the law is the idea that professionals are not to be trusted to regulate themselves, HPC functionaries are.

Before 2001 it was enough for politicians to say ‘we don’t think these professionals are ready to be handed statutory power’. A strong reason for this was the lack of a coherent body of knowledge to bind the field into one. Now it is said that we can make the field into one by defining it as a threat to the public, and then creating a new statutory body to police it.
The HPC appeared as the one organisation incapable of corruption. The benefactor of its virtue was The Public whose vigilance against sinful aspects of itself was needed to make the thing work.

The idea that the HPC is incapable of corruption is linked to the idea that it cannot think for itself but gets its instructions from something unnamable and powerful. This might explain why the professional links to the HPC are largely shrouded in mystery. There are three sacred tomes: Standards of Proficiency, Standards of Education and Training, and Standards of Conduct, Performance and Ethics.

Any problems associated with these three great questions are swept aside with a combination of strategies: consult legal advisors; appoint friendly panels of experts; set up bureaucratic procedures which are somehow not of their own invention nor subject to their influence.

Each of these routines can be seen at work in any of fitness to practise hearings. Today’s example is of a complaint that was prevented from entering the process. This is a part of the picture that rarely gets exposed, but it is nevertheless instructive in that it reveals once more revealing the way in which the HPC interprets its mission and reveals what it considers a sin.

It is worth holding in mind the recent case of psychologist and HPC Council member Malcolm Cross (an excellent report of which is posted on the HPC watchdog blog, written by Bruce Scott). The contrast reveals the working assumptions about the nature of the public the HPC feels it worth protecting, about the kind of sin that it needs to protect the public from, and also about the potential for vested interests to make themselves felt.

The setting, as usual, is the NHS. An employee suspects he is about to be downgraded when a manager re-writes his job description. There is a specific clause in the job contract forbidding unilateral changes, and he suspects the manager is trying to avoid a redundancy situation. He complains to a more senior manager who sits on the paperwork and does nothing about it. The employee (who does not belong to a trade union) engages a lawyer and complains to the Trust. He is vindicated and the managers are prevented from breaking the law. A few weeks later an incident arises at work and the two managers use it to effectively get rid of the thorn in their side. So the employee complains to the HPC that the two managers are acting unprofessionally – the main contention was their intention to break the law by rewriting the job description and failing to activate a grievance.

If Dr Cross’s dinnertime antics register as a possible harm to the public, why does this case not also make the HPC alarm ring?

Here is what the HPC said: “I … understand that both complaints were closed on the basis that the concerns you raised were not considered to relate to the registrants’ fitness to practise as registered professionals.”

The letter is signed by the head of case management who explains that someone else has given her to understand that, following due process, they have judged that the actions are nothing to worry about. She continues:

“Please be advised that your complaints were closed following legal advice from the HPC’s legal advisor. The complaints were not considered by a Panel of the Investigating Committee.”

There is something curious in the form of the letter. In a Humpty Dumpty way she writes: legal advice was gotten from the legal advisor. In repeating the phrase she avoids saying who is actually responsible here, and conjures up the mystery of He whose name cannot be spoken. The repetition effectively creates a screen behind which we may not go. We have to trust that this manager has the experience and wisdom to know that this ok, but we know nothing about her nor how she’s been put to the test. The legal advice also stops the complaint from entering the formal process – it does not go in front of the Panel of the Investigating Committee (populated by registrants and lay-people recruited and trained through the HPC).

She continues:

“I am of the view that the complaints you made against X and Y do not raise public protection issues …

The emplyee’s point was that x and y were trying to over-ride the law to implement their own, local, agenda, and might have used the power of the institution to damage his own less powerful position.

“I am satisfied that your complaints were investigated fully and dealt with appropriately …
Investigated fully? It was legal advice from the legal advisor, not Investigation by the Investigation Panel.

… “Should you remain dissatisfied with the HPC’s decision to close your complaint, it is open to you to make a complaint via the HPC complaints process.”

Such convolutions do not inspire confidence, and neither does the fact that the complaints manager is another HPC employee.

“You should address your complaint to: Mr Greg Ross-Sampson, Director of Operations, HPC…"

Presumably Mr Greg Ross-Sampson will go to the same legal advisor for legal advice and catch our complainant in the same infernal loop.

This complaint has many aspects, and the situation remains in dispute. One of the complications is that the complainant discovered that the manager he was complaining about was the chair of his professional organisation. He now suspects that the manager’s position in the hierarchy, coupled with his liaison with the HPC, has effectively scuppered his complaint. The promise of protection was offered, and this public was disappointed. No ameliorating mechanisms were put into play.

Andrew Marr nailed the problem within the first few minutes of Easter’s Start the Week (BBC R4, Monday, 4 April 2010). In conversation with the Archbishop of Canterbury, Marr said ‘It seems to me that the core of the problem is that of being an institution, because every institution wants to protect itself as an institution’. This, of course, is not news (Max Weber said much the same thing about a century ago), but perhaps more interesting is that Marr was talking not only to Rowan Williams but also to Philip Pullman whose new book (The Good Man Jesus and the Scoundrel Christ) novelises exactly this dilemma. “What we are talking about is the difference between the institution and the essence,” said Marr. Rowan Williams thought a central theme of Pullman’s books was the question of the ‘price you pay for transmitting, in institutional terms, the message’. Pullman thinks the price too high, Williams does not.

Prof Mona Siddiqui tried to elaborate on this difference by reminding everyone that these differences of opinion exist amongst many religious. For example, the Sunni and Shia sects of Islam have almost opposite relationships with bureaucratic structure. Unfortunately, her point was lost as soon as Marr asked: ‘Is it possible to have an effective religion without a huge bureaucracy? To which Williams replied: ‘You need some way of recognising from generation to generation that you are talking about the same mission’. The question became: ‘Does the religion, does the structure, have enough in it to rein the people back from less relevant ends?’

David Baddiel (whose new film The Infidel directed by Josh Appignanesi is out this week), said the urge to institutionalise, along with the tendency to split and form schisms can also be found among atheists.

Mona Siddiqui raised the question of love by distinguishing between institutional expressions of religion (which give context and reference points for people to make sense of it), and the creation and exploitation of sacred leaders. Again, the point was left when Pullman set off on a slightly different tack: ‘There is always an original visionary who speaks about a time that will be coming soon when heaven will be fulfilled and earth will be full of plenty. Of course it doesn’t happen, so an institution is set up in order to validate the vision’. He could have been speaking of politics.

Both Marr and Williams picked up the thread and talked about rules, codes, tick boxes, and the collection of scores to ‘prove’ the truth of the vision. Williams thought ‘this is one of the things that the gospels do try to undermine’, and a bizarre wager was made when the writer pessimistically bet on bureaucracy to always trumps literature, and the Archbishop (optimistically) backed literature to triumph over bureaucracy.

Baddiel thought that the function of bureaucracy was to inject the greater truth into the story and noted how some people could then cash in on the power. Williams thought that this was too instrumental a version, and that it gave people too much intentionality. It is not, he said, really the way a lot of these things start out. But he might have conceded it was the way that a many things proceeded, especially when cut off from the original plot.

But then a pearl of wisdom was dispensed. The Archbishop said: ‘Something happens that releases an explosion of puzzles, more than language can cope with, which leads to a very complicated period. This is when you begin to see the start of bureaucracy.’

He could have been speaking of a pregnancy, a terrorist attack, the triggering of a psychosis, or the conception of the HPC.

Guest post by Bruce Scott on the FTP hearing of Malcolm Cross

A case of dialectical disease: A tale of a Health Professions Council fitness to practice hearing of a psychologist.

Bruce Scott
Philadelphia Association, London

Whilst attending the Health Professionals Council fitness to practice hearing of Dr. Malcolm Cross on the 15th and 16th of March 2010, a conversation came to mind that took place between the playwright and poet Goethe and the philosopher Hegel in 1827. Their conversation highlighted the problem of “dialectical disease” of what this hearing, I felt, was suffering from. The conversation between Goethe and Hegel went as follows:

The discourse then turned upon the nature of dialectics. “They are in fact” said Hegel, “nothing more than the regulated, methodically-cultivated spirit of contradiction which is innate in all men, and which shows itself great as a talent in the distinction between the true and the false.”
“Let us only hope,” interposed Goethe, “that these intellectual arts and dexterities are not frequently misused, and employed to make the false true and the true false.”
“That certainly happens,” said Hegel; “but only with people who are mentally diseased.”
“I therefore congratulate myself,” said Goethe, “upon the study of nature which preserves me from such a disease……I am also certain that many a dialectic disease would find a wholesome remedy in the study of nature.”

It became clear during the course of the hearing that it was afflicted with this “dialectical disease” as they (i.e. lawyers, judging panel, complainants etc) were focussing upon and arguing about the notion of what amounts to “misconduct”. In effect they were trying to make the false true and the true false in their logical argumentations of what constitutes misconduct. As I sat in stunned silence, a fear came over me. I felt unsafe amongst these diseased dialecticians as the concerned parties , for what appeal to reason, or to nature as Goethe advocated, would or could be heard? Human nature had been left aside, human freedom had been forgotten, and common sense had been replaced by an authoritarian pseudo-psychological medico-empirical scientific dialectic pertaining to the notion of misconduct that was divorced from any “alternative” or freer way of looking at misconduct (if it could be called that). This lead to an abusive and violent hearing and sad conclusion to the hearing. Let me explain why.

The facts of the case have recently been circulating within various media (i.e., newspaper reports), but let me summarise . Dr Cross was the Chair of an accreditation team (4 in total) visiting a university to carry out its evaluation of a university counselling psychology course to see whether it was up to the job of being accredited with British Psychological Society (BPS) validation. The team met the night before at a hotel and had a brief discussion about the paperwork and any issues pertaining to the accreditation visit. Dr Cross felt (as Chair of this team) that there was very little to go over and that everything was in place for the visit the next day. Then team then went for dinner to a restaurant along with the wife of one of the team members. At dinner wine was drunk (4 bottles in total) and everybody was drinking. Dr Cross was not working as a psychologist at this dinner; neither were any other of the team in their respective roles. It was purely a social occasion. I will relate the facts of what happened during this meal in a moment, but suffice to say, Dr. Cross carried out his duties the next day as the head of the accreditation team perfectly well. Indeed, all the members of the team, which included the two complainants against him, described his performance the next day as “exemplary”. So one might ask what was the problem that occurred the evening before?
During the course of the dinner (and short informal meeting before dinner) Dr Cross was accused of:

1) Being drunk (at the dinner and when he arrived at the hotel for the informal accreditation discussion).
2) Being rude, lewd and condescending during the course of the evening.
3) Touching himself in a sexual manner.
4) Making sexual gestures to two of his colleagues: trying to kiss, express his love and offer oral sex to one colleague and touching the leg of another.

Some people may jump to the conclusion that these events are indeed misconduct and in need of judicial/HPC treatment. Such people might shout, “What! A psychologist drunk, rude, condescending and being sexually disinhibited! What scandal, strike him off, take him to the gallows!” Well obviously some people did, and it went through the laborious administrative process at the HPC and thence to hearing.

Here is an extract from a clinical psychology internet forum from a blogger after I had alerted their attention to the case of Dr Cross and the nature of HPC hearings . This blogger’s comments highlight the pervasiveness of diseased dialectical processes in the pro-HPC camp. It clearly does not see everything as it is in the clearing to quote Heidegger .

“….it would be highly concerning to me that such behaviour might have an impact on the people they work with, and beyond a certain threshold it would be appropriate to make a complaint. After all, a complaint is then investigated and a hearing is held, where parties can appoint solicitors, in which the person can challenge the allegations, and other witnesses can be called, and their peers can comment on their behaviour and what is outside of acceptable limits.”

Well, that makes it all ok then! Bring on the trial, justice will be done, the law will prevail – or does it?

The HPC lawyer cross-examining Dr Cross obviously believed in such a process. In her summing up of the case she brought the hearings attention to point 3 of “the Standards of conduct, performance and ethics” of an HPC registrant. This states:

“You must keep high standards of personal conduct, as well as professional conduct. You should be aware that poor conduct outside of your professional life may still affect someone’s confidence in you and the profession.”

Following on from this, point 4 on the Standards of conduct, performance and ethics states:

“You must tell us (and any other relevant regulators) if you have important information about your conduct or competence, or about any other registrants and health professionals you work with.”

The HPC lawyer then went on to argue that one has to consider the wider public policy (i.e., protection of the public). She argued that Dr. Cross’s behaviour was evidence of misconduct and was of interest to the confidence and safety of the public as he is a psychologist and treats vulnerable people. Concluding, she argued that the alleged misconduct of Dr Cross is evidence of his impairment of his fitness to practice. She referred to a case brought to the attention of the General Medical Council a few years ago where a Doctor had crossed the boundaries of the patient-doctor relationship (the Doctor had sex with his patient which was consensual). When I heard her mention this case I thought to myself what relevance is this to Dr Cross’ case.

These assertions of misconduct were bolstered earlier in the hearing by the fact that one the complainants (a psychologist) argued, whilst on the stand giving evidence, that Dr Cross’s behaviour was indicative of a potential serious problem that needed to be addressed. Don’t forget, this complainant had also been drinking on this evening. He confessed to drinking three glasses of wine. Perhaps it was more, maybe 4, or 5 perhaps. The second complainant (a British Psychological Society secretary whose role it was to takes minutes during the accreditation meeting the next day) was, according to the testimony of all others who gave evidence, texting, twittering, or emailing on her mobile or blackberry throughout the dinner. She accused Dr Cross of being rude to her and belittling her. She said he was nicer to everybody else compared to her. Dr. Cross had said to her that if she missed her friends that much, she should have stayed at home. Doesn’t the new DSM manual have a new disorder called something along the lines of “internet addiction” which leads to difficulty in social interactions and interpretation of social cues and interaction?

My mention of binge drinking and internet addiction is said with tongue in cheek. I was quite surprised that the HPC panel, the HPC lawyer, and Dr. Cross’s lawyer did not bring these facts up for any real discussion. However, the lay member of the panel did mention that she would find such “twittering” behaviour very rude.

Yes, Dr, Cross did admit to trying to kiss one of the accreditation team, told him he loved him and offered to give him oral sex. But he did say it was a joke, a bad joke perhaps, and not well received by one member of the team. The other male member of the team in his statement to the hearing (a paper submission) reported that he just laughed at Dr. Cross’ disinhibited sexual jokes and antics and did not think they were serious, and he was not offended by them in any way and neither was his wife who was also present.

So, the panel adjourned on the second day at around 11.15am to see if Dr Cross’s behaviour amounted to misconduct of an HPC registered psychologist and if it amounted to an impairment of his fitness to practice. I had to wait for 6 hours to be called back for the result.

Luckily for Dr Cross, although the panel thought that he was drunk, lewd, and rude, it was not proven if he touched himself in a sexual manner (evidence submitted showed that the complainants could not see this occur as he was sitting in such a way that he was obscured). It was also not proven that Dr Cross was serious in his gestures of love and affection to people at this social occasion. The panel ruled that his behaviour did not amount to misconduct and thus the allegation of misconduct was not well founded. “Justice was done!” the pro-regulation brigade might shout at such a result. “You see,” they might say, “it is a good process, everything was done above board, witnesses were called, and he was cleared.”

Was he cleared? Is Dr Cross in the clear? Not according to the newspapers. He was written about as though he was guilty. The story was sensationalised with all the lewd bits highlighted to the omission of more balancing facts; that two other people were present at the dinner and they thought Dr. Cross’s behaviour was fine; disinhibited, joking, and fun yes, misconduct, no. It was not reported that nobody left the dinner and walked out in disgust; everybody enjoyed a two-course dinner with wine. It was not reported that everybody was drinking, and that no restaurant staff or diners made a complaint about Dr Cross. It was not reported that the BPS, who had been initially consulted about this incident by one of the complainants, wanted to deal with the incident in house. But this complainant was not satisfied with this; it was subsequently taken to the HPC. A grudge perhaps? More importantly, it was never reported in any of the newspaper reports that Cross was not on duty as a psychologist at the time, and also that he carried out his duties in an exemplary fashion (to everybody’s testimonies given) the next day.

What was most upsetting to me just when the HPC panel finished delivering their verdict, Dr Cross broke down into tears, and rushed out of the hearing room. Nobody flinched. I was almost brought to tears myself witnessing this. It was terrible. Dr Cross had been brought to trial, and I call it trial because it had all the hallmarks of a legal trial, and his reputation has been “sullied” by the press and his colleagues and the HPC process in a most disgusting way. This will no doubt affect his working life and livelihood and perhaps even his personal life and relationships. But never mind, justice was done, he was cleared. Of course, I am being ironic in this last statement.

I think at this juncture it might helpful to again look at this idea of “misconduct”. Dictionary definitions of misconduct pertain to: behaviour not conforming to prevailing standards of law, bad management by persons entrusted or engaged on another’s behalf, and deliberate wrongdoing, especially by government officials or military officials. The thesaurus, just for interest, gives some unsurprising results: to behave oneself improperly, rude behaviour, horseplay, and naughtiness.

There are also legal definitions of misconduct. These pertain to ideas of wrongful, improper or unlawful conduct motivated by premeditated or intentional purpose or by obstinate indifference to the consequences of one’s acts.

There are many other definitions of misconduct, but to draw the reader’s attention to these most common and helpful one’s presented here and re-direct the reader above to the HPC standards of conduct, performance and ethics (points 3 and 4), it is clear there is a huge scope for the application of misconduct that the HPC can pursue. Therefore it is clear from this that the HPC has become a dangerous monster. It is quite clear, that in their use of their idea of what constitutes misconduct, the HPC have in effect committed misconduct (mismanaged) themselves in the case of Dr Cross.

Why do I charge the HPC with misconduct in the case of Dr Cross and in general of becoming a dangerous institutional monster? Taking into consideration the scope of what misconduct can cover, and also how the HPC standards of conduct, performance and ethics are laid out, their system is open to abuse, as has occurred in the case of Dr Cross, by the HPC, registrants and patients or the general public. Points 3 and 4 of this document covers personal conduct but also the proviso that a “registrant must tell us (and any other regulators) if you have important information about your conduct or competence, or about other registrants and health professionals you work with.”

This framework encourages denouncements by colleagues and negates the possibility of talking to colleagues about problems, encourages defensive personal and professional conduct, and promotes a lack of trust in oneself or the possibility of efficient self-reflection. I think this is what Michel Foucault calls the panoptic society whereby, we overly self-govern ourselves out of fear of being caught out by the surveillance of the institution that makes the rules.

The HPC has however has wildly distorted any ordinary self-governance so that people denounce their colleagues to those who pretend to be the guardians of the public. In other words, we cannot act freely because the “Big Other” as Zizek explains, is always in the background, haunting our being, and robbing us of our ontological freedom. The HPC mistake themselves for the “Big Other”, in a Big Brother Orwellian way. Others are watching our behaviour for any flaws and will report this, not to us, but to the HPC. But we even have to watch out for our own flaws, and must report ourselves to the HPC if we notice any in ourselves. Has the HPC panoptic machine not gone too far?

It is clear from the HPC’s framework, that anybody who is offended by somebody’s (e.g., a psychologist) conduct such as swearing, smoking too much, not sleeping properly, being unfaithful, driving too fast, being late for work, eating unhealthy foods, spending too much time shopping or watching too much television, could make a complaint to the HPC. The examples I list could all be classed as misconduct. But please note, it also depends on who is offended. Some might be offended by such behaviour, others not. This is what occurred in the case of Dr Cross; some people were offended, or perhaps frightened by their duty to the HPC panoptic machine. Or was it because that they felt he didn’t like them as much as they thought or wanted him to like them?

What I am trying to say is this; was there not a better way to do things in the case of Dr. Cross and does the HPC not realise (maybe it does) that their dialectic concerning misconduct has reached monstrous proportions? I put it to the HPC that they have breached their own codes of what amounts to misconduct. They have badly mismanaged their position; protection of the public, and brought a case to hearing that had already been dealt with by the British Psychological Society. This case could have been dealt with (by the BPS for example) in a much more humane, civil, and satisfactory manner). Instead, they have infantilised a profession (psychologists) by encouraging them to snitch on colleagues for matters that previously could be dealt with face-to-face or in-house at work. In the past one could actually talk to a colleague or have word with your manager if someone offends you or if you are concerned about someone’s behaviour. But it seems that such simple gestures seem to be regarded by pro-HPC persons and bodies as obsolete and unreliable; we cannot be trusted anymore! God forbid the HPC cry, stop people from negotiating personal and professional relationships by talking to each other. Dr Cross has been dragged through the papers and his reputation sullied by offending two people. Dr Cross is a member of the public and has not been protected by this shambolic process. The HPC’s fitness to practice is impaired as they have damaged a psychologist’s career and livelihood (and perhaps eroded what it means to be human and the freedom of what this entails) whilst disregarding their ridiculous standards of conduct, performance and ethics of how they deal with misconduct.

We do unfortunately live in world where we will at some point offend someone. We will get up peoples noses and have disagreements. We will all also live lives and engage in behaviours that others will feel are unhealthy, dangerous, and in need of change; we all will. So the sorry state of affairs we all have to accept is that all psychologists, psychotherapists, and counsellors will at some point break the HPC standards of conduct, performance and ethics, and so will the HPC. Let’s all hand ourselves in and get it over and done with! The rock solid idealism of the HPC and how an HPC registrant should be is a fairytale and represents a quite frightening delusional fantasy of what the world should be like. The way the HPC lawyer and two complainants spoke about misconduct painted a picture of reality where no risk, fallibility, or pain (psychic) should enter human life or behaviour. This is dialectical disease.

We live in a world where there are unjust wars being waged (by our own and other governments), there is the banking crisis which exacerbates the greed and deceit by the bankers, politicians are fiddling their expenses and engaging in dodgy lobbying for private companies which affects government policy. The gap between rich and poor is bigger than ever, and there are thousands of homeless people roaming the streets of our country who do not have a warm bed to sleep in or hot plate of food to eat. Thus, I ask, why is it that health professionals (and psychotherapists and counsellors) are being targeted by such a massive projection or demand for “safety” (by the HPC and society in general). I feel we should take Lacan’s lead and seriously look into this demand and see what it has to say. I think underlying this demand may be something quite sinister or at least, fraught with dis-ease. However, I think we have right to feel ill at ease in today’s times, but I feel it is a cheap shot to target health professionals (and psychotherapists and counsellors) . The last thing we need, considering the state of the world today, is a panoptic state breathing down our necks accompanied by a diseased dialectic of what it means to be human or a psychologist (in his or her personal life). The HPC and similar constrictive institutions seem to want to impose a world view where no risk ever takes place, where human beings conduct themselves like robots and are rewarded for perfect behaviour, but severely punished for straying from the (ur) model.

I wonder what Goethe would have thought if he had witnessed the HPC hearing of Dr Malcolm Cross? I am certain that he would have felt that HPC’s dialectical disease would find a wholesome remedy in the study of the nature of the situation, instead of a dialectical process of trying to make the true false, and the false true, which is what occurred on the 15th and 16th of March 2010 in Kennington, London.


Footnotes
i Conversations of Goethe, with Johann Peter Eckerman. Da Capo Press (1998). Extract taken from page 244.
ii The HPC lawyer, Dr. Cross’s lawyer, the “independent judging panel, and witnesses including Dr. Cross.
iii There is no record of the case or the result of Dr. Cross on the HPC website for the public to consult. I have been in touch with the fitness to practice hearing department at the HPC and they told me that as this case was “not well founded” it automatically becomes deleted from the past hearings list. However, if Dr. Cross wished his hearing details and result to be left on the list (for whatever reason), it would be left on. However, other similar cases’ details and results have been left on the list. It remains to be seen if the HPC have “erased” the case of Dr Cross Orwellian style, for fear of what this terrible, abusive, and highly mismanaged case might signify to a public critical of the HPC regulation of psychologists, psychotherapists, and counsellors.
iv www.clinpsy.org.uk
v Martin Heidegger. Zollicon seminars: Protocols-conversations-letters. Published by Northwestern University Press in 2001.
vi Michel Foucault. Psychiatric power: Lectures at the College de France, 1973-1974. Published by Palgrave Macmillan in 2006.
vii Slavoj Zizek. How to read Lacan. Published by Granata Publications in 2006.
viii Jacques Lacan. Ecrits. A selection. Published by WW. Norton & Company in 2002.
ix I do not subscribe to the view that psychotherapists or counsellors are health professionals.