Psychotherapy and counselling in the post-truth era

Welcome to the post-truth era – a time in which the art of the lie is shaking the very foundations of democracy and the world as we know it. The Brexit vote; Donald Trump’s victory; the rejection of climate change; the vilification of immigrants; all have been based on the power to evoke feelings and not facts.

Thus starts Matthew d’Ancona’s (2017) ‘Post-Truth’, written one year after the Oxford Dictionary voted ‘post-truth’ word of the year. So, what of the psychological therapies in this era of post-truth? Have they enabled or disenabled clients to distinguish feelings from facts?

Questions of truthfulness are not new in the psychological therapies, much has previously been written about, for example, suggestion masking itself as interpretation (Lacewing, 2013; Szasz, 1963) and more recently, questioning where recovered memory has been false memory (Porter, Yuille, & Lehman, 1999). Where then can people go in a world where we are increasingly being shown how the social media is manipulating its users voting intention unknown to them, as in Cambridge Analytica (Greenfield, 2018)? We are also in an era Where universities have become businesses with income streams and league tables competing for a primacy over endeavours to seek truth and justice let alone questioning what communities they might be serving? So, how have all these cultural changes affected the extent to which individuals can explore with a psychotherapist differences between fact and fiction in their lives? Yet psychotherapists, themselves are increasingly subject to technological therapeutic approaches that have been designed so that they can apparently be researched. Increasingly therapists are asked to specify their approach, for example DIT, DBT, ACT, CfD, etc. Being more broadly based is increasingly less acceptable.

All this flies in the face of philosophical traditions where, for example, for Gadamer (2013), if you want truth you cannot have method. Again, for Levinas (1969), truth and justice might only occur very rarely between therapist and client. Yet, we are in a world of increasingly manualised therapies where it is considered possible, and necessary, to measure success on universal scales – even at the end of each session! For those trained more traditionally, this may sound like a joke; but, it is not for those who lose their job if they don’t as therapists comply and show improvements. An even greater problem in our post-truth era is the dominant cultural practice termed CBT. Its primary purpose can be seen to help people take their mind off their problems. So, there are fewer and fewer opportunities for thoughtful therapeutic practice and a lack of congruence within therapist or client is ignored if not encouraged.

It could be argued that other modalities are dogma ridden (rather than CBT which attempts to be science based), disenabling anyone to really come to their senses! However, this is even more difficult in our post-truth consumer era. For, as with university lecturers and the medical professions, we can no longer tell our clients, students or patients, what we think or feel about them. They are all now consumers and our professionalisation comes to mean that our ‘customers’ must be gratified and anything resembling unpleasantries must be very carefully packaged if they are to appear at all. This is not out of respect for the other, but to protect the professional (or now, semi-professional) within post-truth’s consumerist managerialism and hence to succeed as a business.

What if anything can be done? Whilst it is important to protect clients from potentially abusive therapists, it is also vitally important that therapists are protected as much as possible from consumerism, post-truth’s antecedent, if they are going to put their clients first. This requires not only a strengthening of the professional bodies to provide more appropriate balance in protecting the therapist as well as the client, which may have gone too far in the latter’s favour after Shipman et al.; but also a change in the training of therapists if they are ‘to be in the world with others’ (Heidegger, 1962). Therapists in attempting to be clear about their own thoughts and feelings need not only their own personal therapy to consider both, but also to be educated in the cultural, social, economic and ideological worlds we are in as therapists and clients. Then, we will be more able to allow our own thoughts and feelings to emerge between ourselves and our clients and to communicate them where appropriate for our clients more than for ourselves and those such as the state influencing us away from seeking truth and justice.

In the first paper of this issue of the EJPC entitled ‘Topic-focused analysis in a case of integrative psychotherapy with a father fearing his own anger’, Sissel Reichelt; Jan Skjerve and John McLeod explore the short-term treatment of an angry patient in which an experienced therapist utilises an integrative approach. The therapist addresses the patient’s underlying feelings of hopelessness, helplessness and self-blame, helping the patient see that his anger is a manifestation of his underlying depressive position. Here, the authors clearly show the limitations of defining anger as a problem in and of itself, and in so doing provide research that illustrates treatment in an engaging and emotionally compelling way.

‘Psychoanalytic perspectives on paraphilias and perversions’, our second paper by Jessica Yakeley is a valuable paper, of immediate practical use to therapists. In this paper, Yakeley addresses how therapists might be thoughtful about helping clients whose sexual desires and practices cause anxiety to themselves and/or others, particularly in the domain of intimate relationships. The author is acutely aware of the problematic nature of the nomenclature to which psychoanalysis has recourse, of how ‘perversity’ has come to be an indelibly negative term. This paper is thought-provoking about therapists working difficulties and the importance of the context and frame, and informative about a range of theories about ‘perverse’ sexual behaviour.

Our third paper, ‘Existential Psychotherapy and the Therapeutics of Activism’ by Rebecca Greenslade, develops a well-presented case for considering cultural practices within psychotherapy from an existential perspective. Greenslade, develops an original and thought provoking argument towards a more humanised and holistic form of therapeutic practice that considers the person and not a pre-existing therapeutic agenda. A significant piece of work with far-reaching implications that highlights the challenges faced in today’s culture of psychotherapy.

‘Tears in therapy: A pilot study about experiences and perceptions of therapist and client crying’ is our fourth paper. Catelijne ‘t Lam; Ad Vingerhoets and Lauren Bylsma aim to gain insight into therapists’ experiences and approaches towards their own tears and those of their clients. Findings revealed that not only client crying, but also therapists crying is common within the therapeutic experience with therapists holding that their tears should be shared in a professionally responsible way that lends support to the therapeutic process. A welcome pilot study that will hopefully lead to further research of this important topic especially in the training of therapists.

The final paper, ‘Medicalizing tensions in counsellor education?’ is by Tom Strong; Konstantinos Chondros; Vanessa Vegter and Christiane Job McIntosh. The paper raises awareness of curriculum and supervisory ‘tensions’ associated with medicalisation in graduate counsellor education as well as practice issues that plague contemporary understandings of ‘mental health’. It situates these professional issues in the broader cultural context in a clear way and interesting ways. The paper is excellent, timely and important in current circumstances. Again such ‘medicalisation’ can also be seen as unhelpful; but, to return to the subject of this editorial is very different to a post-truth disembodiment which is frighteningly becoming the new manualised normal.

Del Loewenthal
Department of Psychology, University of Roehampton, London, UK
[email protected]