Saturday, 6 January 2018

The modern psychotherapies

Out of a book, a course is born

The book of the non-modern psychotherapy
One of the advantages for modern psychotherapies is that they are in keeping with the times: they are easy to understand, generally positive, low risk and populist. The processes that clone, replicate and implement them ‘at scale’ are industrialised and commercialised for maximum market penetration and efficiency. An individual or team of individuals can conjure up a ‘new’ therapy out of elements that most psychotherapists have known for years, simplify it as much as possible, define it exactly, research it, write a manual and – if they have done it well enough – hit the jackpot and become celebrity academics. A neoliberal success story – rock on!

One of the problems with the world of therapeutic communities is that they don’t fit this modern way of doing things. They have been around for decades, if not centuries, and nobody could or should claim any sort of ownership of them. They are fundamentally counter-cultural, anti-individualistic and strongly communal. Therefore, the corporate and industrial processes that work for modern psychotherapies will never be acceptable to their members or champions. These processes don’t allow for democratically incremental and reflexive change and development of the field, don’t recognise the inherent complexity and uncertainty of depth approaches, and deny the need for a critical or whole-system approach. The modern psychotherapies are managed into a state of fixed and reified sterility. Which means, since the late 1980s, therapeutic communities have been left out in the cold: in a state of moderate decline and all but forgotten by all but a few aficionados.

However, a few have adapted and modernised themselves to survive – hopefully without ‘selling out’ – although the rest have gone to the wall, and Empire is now Striking Back – with three prequels. The first has been to gather up all the therapeutic communities into a ‘Community of Communities’ and have a process to agree together what they are all doing, help each other with it, and make it accreditable. The second is to grit one’s teeth, screw one’s courage to the sticking place, and finish a research project which has been declared well-nigh impossible by anybody who has thought about it in the past. The third is to get together with everyone’s favourite friendly independent publisher, and publish a book about it all. The two people responsible for the first and second prequels are the co-authors.
The course of the book of the therapy

So now the book is there, it needs to earn its living – by making therapeutic communities, and therapeutic environments, spring up in new places, and bring the whole therapeutic communities movement back to life and rude health. It was a powerful social force in the heyday of social and emancipatory psychiatry in the middle of the twentieth century, and many feel the need for a twenty-first century version: mental health as a social movement.

One way we are starting this do this is by stealing a trick from the ‘modern therapies’ by mounting a practitioner training course. It is based on the book, and includes as many therapeutic goodies as it is possible to get into a course little over a year long. But those who complete the course will be able to call themselves ‘therapeutic community practitioners’, have confidence that they are doing something that is both age-old and evidence-based, as well as being thoroughly human. They will bring the quiet revolution to a mental health service near you. 

May the force be with them!

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