Thursday, 26 May 2011

On Being Ordinary

I've just finished reading Cultivating Intuition: An Introduction to Psychotherapy, by Peter Lomas, a British psychoanalyst and writer I hadn't encountered before (thanks for the tip, Hilary). Lomas has a strikingly direct and down-to-earth approach and 'voice' which I found immediately engaging, and trustworthy. The broad drift of the book's argument is that psychoanalysts need to shed their reliance on a mystique of special knowledge and expertise, and the special (or, perhaps more accurately, peculiar) way of relating to the 'patient' that follows from it. They should risk, he suggests, being more ordinary:

Given that she will fall short ... of an ideal helper, what qualities should the therapist display in the relationship? These, I believe, are primarily those that are required in ordinary living whenever, and in whatever way, we aim to facilitate the well-being and growth of another - in teaching, in social work, in bringing up children, and so forth. These are the qualities that most of us would probably list as the virtues of a good and mature person: strength, honesty, patience, humility, humour, shrewdness, a capacity to love, and so on. These are not, of course, capacities that the therapist can produce out of a hat any more than a man can add a cubit to his stature. She can only hope that she is not so lacking in them that she is a menace to her patients, and that such qualities as she possesses and the advantage of a quiet room ... will enable her to give an attentive hearing to the plight of her patients and to feel a response to their intrinsic worth. (16-17)

Lomas is exploring the quietly heretical position (heretical from the perspective of orthodox psychoanalysis, that is) that what matters, what produces results in the therapeutic encounter, is not theory, technique and expertise, but the quality of the relationship between therapist and client. I don't want to suggest that Lomas is a closet anti-Freudian: amongst the many virtues of his book is the way that it articulates the power and usefulness of Freud's core insights. But he is, it seems, trying to bring psychoanalysis more into line with the focus on the therapeutic relationship that has become central to most other orientations since (at least) Smith and Glass's 1977 research review, which suggested that differences in theoretical orientation didn't actually have much to do with the effectiveness of therapy. 

What's also striking though, is that this means Lomas is moving in directions that are recognisably person-centered: 'attentive listening', 'a response to [the client's] intrinsic worth', the 'intuition' of the book's title, which comes through as being pretty much what Rogers means by empathy. I'd strongly recommend Lomas, then, as someone who has useful things to say to the person-centred reader, and says them in a direct, engaging prose which is fed by deep reserves of professional and personal wisdom. But I don't want to co-opt him as a covert p-c practitioner: if I trust him because of what he has to say about intuition, empathy and 'ordinariness', then it also makes me want to listen carefully to what he's saying about why Freud's core concepts are still at the foundations of his practice. Two-way streets tend to be the lively and interesting ones.

Peter Lomas, Cultivating Intuition: An Introduction to Psychotherapy (Jason Aronson Inc.,1993)
Smith, M. L., & Glass, G. V. (1977). Meta-analysis of psychotherapy outcome studies. American Psychologist, 32, 752-780.

1 comment:

  1. "...which suggested that differences in theoretical orientation didn't actually have much to do with the effectiveness of therapy."

    The quality of attentiveness in a good listener may be the thing that saves a life. It's my sense that no theory yet hatched could provide that quality, if it's not there in the person to start with, alas

    Professionals aside (!), people probably vary greatly in their ability to listen.

    I have learned of late that those in most need of a sympathetic listener -- that is, those in pain -- are probably least likely to ever receive that common benison.

    The instinctive mechanism that causes individuals not in pain to shun those in pain is probably not specifically human, of course.

    Barry, I'd guess your own life experience, not to speak of your professional knowledge, would equip you to grasp better than I do all this that I'm fumbling to say...