Dr Nick Read

A Bridge too Far

Psychotherapy is a strange world.  It claims to help people resolve conflict and change, yet the whole profession is deeply split.  The psychoanalysts, humanists and behaviourists are all convinced their approach is only true one, but when it all boils down, there is more to connect different therapies than to separate them.  While claiming allegiance to a particular modality, most therapists develop their technique and attitude from an eclectic theoretical background and would, I think, agree that the success of therapy does not so much depend on the modality as on the quality of the therapeutic relationship and depth of communication. 

Nevertheless, attempts to bring the different therapeutic disciplines together has been beset with difficulties, so much so that the United Kingdom Council for Psychotherapy has relinquished the effort and claims instead to supports diversity, whatever that means.  Clearly integration is seen as a bridge too far. 

Separation cuts deep into the human society.  It exposes enormous ambivalence.  While we desire to belong, at the same time we wish to also be separate, independent, autonomous.  Donald Winnicott captured the resolution of that dilemma, when he said that the aim of our psychological development is have ‘the confidence to be ourselves in the company of others’.  But the company of others implies belonging to certain professional groups, societies or teams that encompass a particular set of interests or attitudes. 

That immediately introduces a split. If we belong to a certain group, we don’t belong to other groups.  While Pi, in Yann Martel’s wonderful allegory, The Life of Pi, might practice as a Christian, a Moslem and a Hindu, he causes consternation among all three sects.  He must choose; he can’t be all three.  The same seems to apply to the psychotherapies.  Psychoanalysts tend to dismiss cognitive behavioural therapy with ill concealed disdain, yet they would agree that the goal of psychoanalysis is for an understanding that brings about a change in thought and behaviour. 

Even the most inclusive societies seem to demand we make a choice.  This starts early in life.  At the age of 14, I had to decide whether I was going to study arts or sciences.  Later I decided to be a doctor, which meant not dedicating myself to my first love, zoology and ecology.  Then I chose gastroenterology and not neurology.  More devastating in its consequences, although I discovered it was possible to love more than one woman, I had to choose one and abandon the other.  To fudge, to be indecisive or deceptive challenges the social order, even though it might make perfect psychobiological sense. 

So perhaps separation is part of our encultured identity.  Society demands difference, encourages diversity.  There must be something about agreement, sameness that does not lead to progress.  Society is like a shark; if it doesn’t keep moving forward, it dies!  Difference and the anxiety and competition this induces, keeps society alive.  If The Government were not continually being challenged by the opposition, then there would be no recovery.  The only time coalitions thrive is when there is an overwhelming external threat.   

So each of us embodies a certain set of beliefs and attitudes that make us who we are and sets us apart from others.  That is socially acceptable as long as understanding and tolerance exists between groups.  It’s when different groups feel attacked for their beliefs and are forced to adopt adversarial positions and ever more extreme attitudes,  that difficulties ensue. 

Unfortunately psychotherapy, which purports to be the most understanding of professions, is riddled with sectarianism to the detriment of therapists as well as their clients. 

We need to built bridges, not broad bridges that reduce everything to its lowest common denominator, but bridges with a café in the centre of them that facilitate communication and understanding.      

At the last meeting of The Hallam Institute of Psychotherapy on July 1st, Keith Tudor, a Humanistic Psychotherapist and co- founder of  Temenos, a Sheffield group promoting Person Centred Therapy, delivered a seminar entitled Building Bridges over Troubled Waters;  regarding humanistic and psychodynamic psychotherapies.