Radhika Holmström talks to practitioners from across the field of psychotherapy about ways that the discipline can help an increasingly fissured society.
Prejudice in our society appears to be on the rise. According to a 2018 Ipsos Mori poll of 11 European countries, three-quarters of respondents agreed that their society was divided, and a clear majority felt their country was more polarised than a decade before.
From the UK, half the respondents cited a divide between ‘immigrants’ and ‘nationals’; followed by differences of religion (47%), ethnicity (41%) and political views (40%) as sources of division. As a society we seem to have lost a sense of identity and belonging to a unified whole. And a currency of ‘othering’ has become commonplace, with groups blaming other groups – and as result individuals attacking other individuals. So, what lies at the heart of these fissures and what role does psychotherapy have in helping to heal the divides?
One issue different groups face is the idea of ‘othering’. Psychotherapist Carmen Joanne Ablack, whose theoretical and practical approach includes explorations of culture, heritage, identity and the intersubjectivity of relationships, says, ‘In reality we are all from diverse backgrounds.’ But by talking about an ‘other’, she says, we avoid any discomfort caused by considering any oppression, power and authority issues that may be emerging within relationships, rather than focusing on them and learning from them.
The media, in particular, have a tendency to other, and help to make and perpetuate divisive and inaccurate stereotypes. ‘Black people, Muslims, have been made into “folk devils”,’ says psychotherapist, trainer and supervisor in intercultural therapy, Lennox Thomas. ‘People feel fear, make misapprehensions and there can even be wrongful convictions as a result of it.’
The internet and social media also play a role in ‘othering’, a particular cause for concern for psychotherapist and UKCP Chair Martin Pollecoff. ‘We get into smaller and smaller holes of reality. The internet, for whatever reason, demands outrage,’ he says. ‘It’s not enough to say “that’s right”; people are told they are disgusting, not fit to hold their office, and so on. We have moved from thinking to feeling, and reality has become, “what I feel is correct”. Social media also lessens our attention span. We can’t concentrate, because something new and shiny comes on the screen, with the mind flipping from one thing to another but unable to maintain a moral compass.’
The consequences of othering and the creation of folk devils are multiple. ‘From my experience, the labels in society give rise to a sense of “them against us”, as well as the segregation of communities who want to huddle together for safety, which then results in further marginalisation,’ says integrative psychotherapist Rozmin Mukhi, who practises intercultural therapy.
‘We need to pay attention to the minority groups who feel disenfranchised. And it’s important for everyone to look inwards, as these prejudices lead to an internalised model of unconscious bias, which is more dangerous as individuals are able to absolve themselves of responsibility for their actions,’ she adds.
Person-centred psychotherapist Ann Simon, who practises multicultural counselling, goes so far as to question whether the term ‘diversity’ is useful: ‘My view is that “diversity” is a semantic term used to disguise the true meaning of integration. The real questions are: what do different racial groups and cultures face when they look at the idea of integration, and what does integration mean to each individual?’
One group often subjected to othering are people experiencing mental health issues. A 2013 report from the World Health Organisation stated: ‘Stigma is a major cause of discrimination and exclusion: it affects people’s self-esteem, helps disrupt their family relationships and limits their ability to socialise and obtain housing and jobs.’
Earlier this year, UKCP joined eight other mental health organisations including the Mental Health Foundation, the Centre for Mental Health and the British Association for Counselling and Psychotherapy (BACP), in calling for the removal of benefit sanctions for people with mental health difficulties.
‘Too many people lose their jobs or are denied opportunities in the labour market because of a mental health condition,’ a statement from the group reads. ‘Too often the social security system treats people with insufficient dignity and humanity. These issues can exacerbate or contribute to mental health problems.’ UKCP Policy and Advocacy Officer Adam Jones says: ‘We wanted to make clear that punishing people on benefits by threatening to reduce or stop their benefit payments exacerbates the problem.’
The statement concludes: ‘No one should be left in poverty because they have a mental health condition. We pledge to work together to achieve an end to the harm we have seen that sanctions can cause.’
The statement reflects the efforts UKCP is making to collaborate with other organisations to ensure equal access to psychotherapy for all. UKCP Chief Executive Professor Sarah Niblock believes that psychotherapy has a critical yet untapped potential to help develop individual and collective responsibility in society towards sensitivity, compassion and respect towards difference. ‘Psychotherapy is a highly informed discourse about what it is to be human, one that bears witness to the harm done by inequality and discrimination to individuals, couples, families and groups,’ she says.
Niblock thinks that it’s crucial that psychotherapy isn’t only seen as a practice in the consulting room. ‘If organisations, councils and government departments are really committed to developing and implementing diversity policies that enrich communities, they would do well to draw on the knowledge and experience of psychotherapists. It may sound simplistic, but many institutions and communities – from zoos to stately homes – have writers or artists in residence who deliver creative programmes and responses to their environment. We need investment in psychotherapists-in-residence to analyse human processes and culture to assess to what extent difference is recognised and valued or marginalised.’
For example, integrative arts psychotherapist Jo Parker wrote in New Psychotherapist, about working as a therapist in residence on an arts programme with the Brighton Oasis Project, a charity supporting women, children and families affected by drug and alcohol dependency. One of her concerns was the people not engaging or who had disengaged. ‘In the field of substance misuse most people don’t even pick up the phone, let alone ask for help. These are the ones most in need of help,’ she wrote.
Psychotherapists can also use their work to address the way of interacting that has led to widespread ‘instant reactions’ perpetuated by social media and the internet, and the tendency to rely on feeling rather than both feeling and thinking. ‘Psychotherapy allows an opportunity to challenge this tendency towards instant reaction,’ says Carmen Joanne Ablack. In particular, it’s important that we are able to challenge our tendencies to dismiss both thinking and feeling, and to dismiss the meaning-making of different groups. ‘Meaning arises out of a context, and psychotherapy enables people to reflect on this,’ she adds. ‘We need to create environments enabling different ways of thinking and meaning-making to thrive, and to come together and understand each other.’
But one of the challenges facing the profession is the extent to which psychotherapy is available to all. ‘Psychotherapy has in the past been a middle-class profession which people from various different cultures and socio-economic backgrounds [find difficult to access],’ Rozmin Mukhi says. ‘I’m glad to say that it is becoming better, but we have a long way to go. The main hurdles are finances as well as resources. This is one of the areas UKCP is aware of and is trying to make it more accessible.’
UKCP is also working to develop a national infrastructure for psychological therapies for people with complex mental health needs as part of the Talking Therapies Task Force, a coalition of six leading psychotherapy and counselling bodies, including the Royal College of Psychiatrists, the Society for Psychotherapy Research and BACP. One of the strands of this work is to secure more appropriate support for people who exhaustively use primary care services without getting the psychotherapeutic intervention that they need at great cost to both themselves and the NHS. ‘We’re calling for more investment in psychotherapy,’ says Adam Jones. We need to either move people to more appropriate services or, far better, to stop them getting to that point of crisis in the first place.’
Lennox Thomas thinks that the exclusion from psychotherapeutic support has other roots too, suggesting that people from minority backgrounds may come up against the view that they cannot use psychotherapies. ‘According to this view we don’t understand the concepts and it may be that we don’t speak English well enough.’
There are some approaches and initiatives that are making this wider embrace more possible – and which are explicitly aiming to heal those social divisions. Thomas is a former clinical director of Nafsiyat Intercultural Therapy Centre, which offers therapy in over 20 different languages. ‘Nafsiyat’s population of therapists are from a whole range of ethnicities and the clients can choose from this – whether they want to see someone from a similar background or alternatively want someone else. All of the people who come into therapy here have had experience of racial insults or slurs, or attack. This is a place where they can talk about it. The new thing is looking at transgenerational trauma: the transgenerational trauma of slavery and how that has shaped psychological development.’
In addition, the Black, African and Asian Therapy Network (BAATN), which offers seminars, mentoring programmes, support groups and conferences, has one primary aim of addressing inequality of access to appropriate psychological services for black, African, South Asian and Caribbean people by seeking partnerships with white majority therapy and training organisations that recognise racism, and the importance of undoing the impact of racism, as an essential part of being mentally healthy. ‘It is about helping those in power (trainers and supervisors) engage and integrate a consciousness about diversity and healthy inclusion that gives equity to multiple perspectives,’ says Carmen Joanne Ablack, who is clinical associate and member of the leadership group at BAATN.
At the same time, we must ensure that our profession does not perpetuate exclusion. UKCP is working with a new coalition of psychotherapy and counselling organisations including BACP, Association of Child Psychotherapists and Place2Be, to address fundamental questions of diversity in the profession. ‘We are very focused on workforce planning, which includes looking at breaking down any diversity barriers to training,’ says Sarah Niblock. ‘Two ways we are doing this are through looking to grow a sustainable diversity bursary programme as well as continually enhancing our processes and standards. We must ensure that our profession does not perpetuate exclusion.’
It’s clear that there are many strands to helping mitigate the divides in society. Psychotherapeutic thinking can help but it needs to be part of the discourse in the ‘big’ conversations in society and critical decision making. Niblock says,
‘In the business world the prevailing view once was that humans could be moulded to fit whatever circumstances best suit profitability. Yet more and more organisations are looking for psychotherapeutically informed leadership and management strategies to create healthier thriving sustainable values-driven companies because the old management rulebooks aren’t working.
‘Imagine a world where there are psychotherapists sitting on boards of directors, on planning committees, on school governing bodies and ideally on all major governmental bodies at local, national and global levels. They would be extremely well-placed to analyse human processes and culture. Instead of these bodies being seen as ‘doing things to’ us, they could start to reframe their perspective more positively by better reflecting the needs of those they impact.
‘I am hugely proud of and inspired by therapists within the UKCP who engage in advocacy and outreach, whether that’s on issues of ethnic diversity, class, gender, and so on. Psychotherapy has an enormous potential, by virtue of the knowledge and experience of serving those who face prejudice, to function as a change agent at societal and institutional level simply by being involved.’
This feature was originally published in The New Psychotherapist, Issue 72, Autumn 2019. To receive a free subscription to our flagship magazine, join UKCP today.