The Politics of Transference
John Heron
This paper was first published in Self
and Society, Volume 18, No.1, 1990. And later in R. House and N. Totton
(eds), Implausible Professions: Arguments for Pluralism and Autonomy in
Psychotherapy and Counselling, Ross-on-Wye: PCCS Books, 1997, pp 11-18.
In 1971 the government published a report on the
scientologists, who were at that time causing much public disquiet. It was
written by a well-known QC, J. G. Foster, who knew very little about
psychotherapy, and therefore took advice from the psychoanalytic lobby.
Following this advice, he condemned the scientologists on the grounds that
they were exploiting emotionally vulnerable people and abusing the
dynamics of the transference. And he recommended the statutory
registration of psychotherapists in private practice in order to protect the
public from this kind of abuse (Foster, 1971).
This led to the formation of a working party on the
statutory registration of psychotherapists in private practice, attended by
all the primary established bodies in the field. Their report hit my desk at
the British Postgraduate Medical Federation, where I was Assistant Director,
some time after 1977. The majority of organizations involved supported
nominal registration, that is, the names 'psychotherapist' and
'psychoanalyst' would be registered, with a list of associations providing
approved training and accreditation. The report argued that this was all
necessary in order to protect the public, quoting with approval the 1971
recommendation.
The behaviour therapists disagreed in a minority report.
They wrote that since there was substantial research evidence that
psychotherapy did not do anyone any good, there could be no case for giving
it statutory recognition. Privately, they put it to me in much stronger
terms. They said that statutory recognition, far from protecting the public,
would lead to widespread exploitation, because it would legitimate
psychotherapists taking money under the pretence of offering a service that
did some good - when studies showed that it did no better than having no
therapy at all.
They also said, in more radical tone, that psychoanalysts
in particular were hypocritical in wanting to protect the public from
transference abuse, when their own therapy was riddled with this very
phenomenon. They let their clients slip into emotionally regressed
attitudes, sustained them there over long periods by manipulative
interpretations, and exploited this state of disempowerment to make money by
recommending an increase in the number of sessions per week. What the
psychoanalysts really wanted, said my behaviour therapy sources, was to
manoeuvre the government into protecting their lucrative monopoly on
transference abuse. Strong stuff indeed, but with an important grain of
truth, in my judgment and my experience.
The report of that working party came to nothing. A
private member's bill, the Bright Bill, based on it was put forward, but the
government, having been advised that there was too much dissension in the
field to warrant statutory intervention, made sure that there was no time
available for the bill to be taken up by parliament. The Royal College of
Psychiatry was secretly opposed to a bill, for fear that it would expose
many of their members, consultant psychiatrists who were, alongside their
NHS appointments, in lucrative private practice as psychotherapists without
any proper training whatsoever.
However, in several European countries, authoritarian and
restrictive legislation was already afoot and in some cases in place. This
has led to the fear that as the UK participates more fully in the European
Community, it may have to take on board after 1992 a pan-European model of
accreditation or statutory registration. Thus the Association of Humanistic
Psychology Practitioners, getting itself ready for 1992 and beyond - or for
any separate UK registration - through affiliation with the Standing
Conference for Psychotherapy, says that applicants must show they have had a
long training and supervision in the understanding and handling of
transference and counter-transference, if they want to be accepted as a
member. The concept of transference again becomes central to the political
argument. There is, however, a disturbing paradox here.
For it is fear that has, in my experience, characterized
the response of psychotherapists to the whole political process of
professionalization. They fear loss of livelihood, loss of status and
recognition, loss of legitimacy. And in this fear I detect a strong element
of transference itself: the acting out of infantile survival patterns in the
face of all powerful authority figures. So the political argument for
professionalization based on legally accredited competence in handling
transference, is itself a rationalization of a more deep-seated transference
phenomenon. This is the paradox. One can scarcely have much confidence in
psychotherapists whose need to have their management of transference
government approved is itself a sign of unresolved transference material.
The case against statutory registration of
psychotherapists, especially the case built on the exclusive
professionalization of transference competence, is as strong as ever it was.
The phenomenon of transference is very widespread throughout our emotionally
repressive society, whose rigidity is sustained by distorted and unprocessed
psychosocial dynamics. People carry around a great deal of buried infantile
distress which drives them to act out in adult life submissive and dependent
behaviours in the presence of those on whom they unawarely project
oppressive parental status. Most professions - medicine, law and the
judiciary, education, social services, politics, to name but a few - exploit
this. The professionals, caught up in the same widespread patterns of
repression, deal with their own infantile insecurity by identifying with
their internalized authoritarian parent, and exercise too much power and
control over their clients - upon whom they unawarely project the repressed,
hurt child within.
If the insecure child within psychotherapists drives them
to use this whole distorted system to legalize a new, exclusive, highly
trained and protected profession to handle transference, they too will fall
foul of their own introjected authoritarian parent - which will subtly
contaminate the way they theorize about and work on their clients'
transference material. In the guise of protecting their clients from the
unqualified, they will oppress them. They will use the transference dynamic
improperly to sustain it. This is the half-a-head-out half-a-head-in
phenomenon: the therapists both have insight into a distorted dynamic
process and at the same time fall foul of it within themselves when working
on it in others. Put in other terms it means that a lot of their
counter-transference is not spotted for what it is and is displaced
unawarely into a warped form of therapy. This is a peculiarly unfortunate
kind of helping treason.
Competence in handling transference by its very nature
cannot, without serious distortion, be professionalized and legalized in an
emotionally repressive society. The professionalization of it takes it away
from the public domain into mystification and expert knowledge accessible
only to the few. And this exacerbates and reinforces the very processes
which it is supposed to be dealing with. There is no better way to sustain
compulsive infantilism in society (and thus an endless supply of clients)
than by setting up a highly specialized, government-protected profession
that alone is qualified to deal with it. This is the ancient corruption of
priestcraft: to organize your hierarchy in such a way that you generate the
sins you are appointed to redeem. It is significant that the pressure for
statutory registration in this field always comes in the first instance
from those who are already caught up in some kind of transference abuse
and want to preserve and protect the improper exercise of professional
power.
The concepts of psychotherapy and therapy are
historically close to the concepts of psychopathology, treatment and the
patient. The tendency of such association is to relegate the notion of
transference to the domain of those who are in a state of psychological
deficit, with emotional problems, and who have fallen out of the mainstream
of social life. This obscures, and distracts awareness from, the fact that
transference is a psychosocial dynamic that affects every aspect of life in
our society. And the relegation reinforces the bad old distinction between
education and training on the one hand, and emotional therapy and treatment
on the other. Once this distinction is made, then education - which is of
universal application - excludes the acquisition of emotional competence,
which is purveyed only by an esoteric profession for a disturbed minority of
citizens. This creates the absurd anomaly that the majority remain
emotionally incompetent, and only patients with problems qualify for
affective growth.
There is another profound anomaly in the argument that
seeks to protect the public from transference abuse in psychotherapy. It
overlooks the fact that one area where transference abuse readily occurs is
in the sphere of religion and the spiritual life. Gurus, perfected masters,
evangelical preachers, traditional priests of all persuasions, mediums
entranced by spirit guides, the hierarchs in psychic and occult groups,
charismatic teachers with a spiritual message - all these abound in our
society today. They generate and often exploit, wittingly or unwittingly, a
great deal of transference material. The exploitation is for purposes of
power, control and dominance; and often for money as well. This indeed is
where the story began in the UK in 1971, with a concern about the
scientologists - who were operating as a church.
There was, however, no talk in 1971 or thereafter about
the statutory registration of practitioners of the spiritual and religious
life, about protecting the public from the transference abuse perpetrated by
many of them. The reason is not far to seek, for such talk would offend one
of our deepest and most cherished traditions - that of religious liberty and
toleration, the right of every person to affirm and practise whatever creed
they choose. To define a religious practitioner, and specify the training
required, for statutory purposes would inevitably protect some limited
dogmatism by law, and cause an outcry that the state was busy with religious
oppression and persecution. A deeper reason is perhaps our tacit awareness
that everyone has a right at some time to be a spiritual practitioner for
others - praying, blessing, invoking, exhorting, healing - and that this
universal right transcends matters of legislation.
So in this field the claims of religious tolerance and
liberty are so strong that they override any concern about protecting the
public from transference abuse. We leave people to find their own way,
through trial and error, and to exercise the right of the pilgrim to undergo
- for however long a period - whatever travails and snares are to be found
upon the path. Why, then, such protective paternalism in the field of
psychotherapy?
The answer is uncompromising and rigorous. To define
transference for purposes of training and accreditation, in order to
underwrite statutory registration of psychotherapists, will enshrine a
limited dogmatism in law. This is logically inescapable: for any definition
is bound to exclude the transference dynamic - for both putative
practitioners and the public - involved in the very pursuit and application
of such legislation. In other words, the widespread social and political
dimension of transference will be absent from the definition. Hence
psychotherapists, in possession of a half-truth, repress their anxiety
involved in handling the whole truth, through the social defence mechanism
of statutory restriction. In claiming legal protection for themselves as
personal change agents, they abdicate their responsibility as social and
organizational change agents. The legislative claim is in reality nothing to
do with protecting the public, but everything to do with protecting the
unresolved transference material - in its social and political dimensions -
of the psychotherapists themselves.
What, then, is the way forward? There seem to me to be
some simple and quite fundamental principles to guide us. The first is that,
both theoretically and practically, the intrapsychic and interpersonal
dimensions of transference are to be seen always in relation to the
society-wide and political dimensions. This leads on to the second
principle, which is that the right to be emotionally competent - which
includes the ability to understand and master the dynamics of transference -
is the birthright of every person in society. Until this claim is
acknowledged, the whole social, organizational and political process will be
distorted by people unawarely acting out compulsive victim, compulsive
oppressor, compulsive rebel and compulsive rescuer roles.
This in turn leads to the third principle, that the right
to emotional competence is an inalienable and central part of the right of
everyone to a proper education. What we need, therefore, is an educational
system for all in which emotional and transference competence is the hub
around which intellectual, technological, interpersonal, organizational and
political competence revolve.
These three principles entail certain consequences for
current practice. We need to interrupt every tendency to hive off the
handling of transference into restrictive psychotherapy. We need
progressively to introduce it into general education. One obvious place to
start is in adult education through the provision of personal development
workshops for the general public. This, of course, has been going on now for
several decades in the UK, both in independent and in institutionally-based
centres. What is perhaps needed more and more on these courses is that
in-depth work on emotional competence should relate the intrapsychic and
interpersonal aspects of transference to the social and political aspects.
The other obvious place to start is in continuing
education, especially in-service further training for the teaching, helping,
management, political and other service professions. What is needed here are
more and more experiential courses in which professional and personal
development are seen as inseparably combined, in which skill on the job has
transference competence as a central component.
The psychotherapists can aid all this educational
development by ceasing to call themselves psychotherapists and by abandoning
the term 'therapy' and the lugubrious and out-moded language of
'psychopathology', 'cases' and 'case-work', 'referrals' and 'supervision'.
They could serve the purposes of social transformation much better if they
were to call themselves affective educators, facilitators of personal
growth, practitioners of emotional competence, and thus stake out a claim to
be central to much needed educational reform. They could quite overtly - as
a matter of policy and public nomenclature - supplement and augment, through
intensive one-to-one tutoring and facilitation, the development of emotional
competence through group-based programmes in adult education and
professional in-service education. And they could still reach out, using an
educational model and working over long periods, to those with special
emotional difficulties.
For it is clear that good psychotherapy does not and
should not involve a treatment and cure model. This model derives from
physical medicine, where the physically diseased and passive patient is
treated by the expert doctor who thus procures a cure. Even in medicine
today this model is now out-moded with a new emphasis on education for
patient power and active self-direction in promoting the healing process.
Where psychotherapy has been contaminated by the treatment model, it has
made the patient too passive - lying back and free associating, and the
therapist too active and controlling - with a series of unilateral,
theory-laden interpretations imposed upon the client's mental process.
To treat the psyche like a body with the fluid of
association flowing through it - a fluid into which interpretations are
injected - is to adopt the method of indoctrination and subtle dominance. It
induces passive regression and may prolong it with a degree of
disempowerment that can turn into sustained depression and, in some
instances, depressive suicide. Some psychotherapists today still use this
method.
By contrast, to relate to the psyche as a person
is to enable, educe and cultivate the client's emerging awareness, insight
and skill in dealing with deep-seated emotional processes. The client is
being facilitated, through active regression, in self-directed
emotional learning and growth. This educational model - of the client
acquiring understanding and skill - is the one which in practice a
large number of humanistic psychotherapists today to a greater or lesser
degree espouse. It is surely time they made this explicit, dissociated
themselves from indoctrination-psychotherapy, and abandoned the narrow and
ultimately self-defeating pursuit of statutory legitimacy.
Of course, on the wider canvas of emotional education,
there are still very important issues about the competence, training and
accreditation of the affective educators, whether working with groups or
one-to-one. But these matters should be entirely outside the jurisdiction of
government and of state legislation, as they are in relation to the
competence, training and accreditation of spiritual teachers.
Our society has already grasped the point that general
education and religion relate to such fundamental human rights that anyone
can, and should be allowed to, set themselves up as an independent educator
or an independent religious teacher. For this is the only way to honour the
right of people to acquire knowledge and spiritual practice from any source
they choose. It also honours the responsibility of people to sort out the
consequences of whatever choices they make. The extension of education from
intellectual to emotional competence only serves to take this right even
deeper - into the domain of self-knowledge and personal mastery.
The right to emotional growth is too profoundly related
to the exercise of human autonomy for the state to have any say in who is or
is not fitted to facilitate it - just as the right to spiritual growth is
too deeply engaged with the inner freedom of the soul for the state to
prescribe who is allowed to foster it. These two rights are closely related,
for emotional growth rooted in human autonomy sooner or later leads over
into spiritual growth expressing the freedom of the soul. It is the business
of the state only to affirm and protect the unfettered exercise of
these twin rights. It is the business of the facilitators of these kinds of
growth to develop forms of training and accreditation that are both
responsible and at the same capable, in terms of their content and method,
of unlimited progression and unfoldment.
The 1989 guidelines for membership of the Asssociation of
Humanistic Psychology Practitioners, in the section which gives details for
applying for full membership, represent a sorry mess. This section falls
between the stool of self-assessment and self-selection of practitioner
categories, and the stool of imposed criteria for the category of
psychotherapist imported from the UK Standing Conference for Psychotherapy.
These criteria are not only imposed, they also appear to be restrictive and
out-moded, implying a total separation - within a closed, hierarchical
professional enclave - of psychodynamics from socio-political dynamics. It
is all very unhealthy, and looks as though humanistic practitioners are
incongruently choosing a form of professionalization quite at odds with the
interrelated values of self-realization and social transformation which have
so far distinguished humanistic psychology.
Foster, J. G. (1971) Enquiry into the Practice and
Effects of Scientology, London, House of Commons Report.