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The Culture of British Psychoanalysis
Robert M. Young
THE PSYCHODYNAMICS OF PSYCHOANALYTIC ORGANISATIONS
People become leaders of organizations for a variety of reasons, among them greater investment of capital, being the son or the son-in-law (who also rises), being the next in line, being a ruthless person. But some rise because of genuine merits, among them special insight or skills, charisma, piety, the ability to confer status on the organization.
The question I want to address is what happens when the qualities of merit which lead people to be placed in leadership roles come into conflict with the other aims of the organization, in particular, democratic process and accountability. Lest this seem too abstract, I want to draw attention to a particularly troubling reflexive quality in some organizations, i.e., when the leaders' special status gets in the way of the ideals of the organization. It is potentially a problem in any organization, but it is a dreadful problem if the organization is specifically set up to do good. Examples come all too easily to mind: corrupt or megalomaniacal churchmen, in particular, revelations about the Catholic hierarchy and in charismatic Protestant sects but also in innumerable cults; ruthless Soviet leaders acting in the name of socialism; trustees of charities who misuse funds.
A fictional example also comes to mind which epitomises the problem melodramatically. In the film, 'Coma' (based on a book by Dr. Robin Cook which he wrote to alert the public to the dangers of abuse of commercial organ transplant surgery) the heroine finally discovers that people are being given carbon monoxide and plunged into irreversible comas so that their carefully tissue-typed organs can be auctioned off to the highest bidder. She goes straight to the sympathetic head of the hospital, played by an ageing Richard Widmark, who says there-there, drugs her drink and sets out to make her permanently comatose by giving her a phoney operation in the room with the special carbon monoxide gas line. Michael Douglas turns up and closes the valve in the nick of time. One reason for mentioning this story is my strong sense that whistle-blowers are at risk, too. People donít tell it like it is when they are young, because they want qualifications. They donít do it when they are in mid-career, because they want to reach the top. They donít do it late in life either because they have reached the top and are implicated and have too much to protect or because they havenít and donít want to be accused of sour grapes. You can make up your own minds about my motives. I believe I am bearing witness about these matters because somewhere in me still lives a fundamentalist ideal about doing good for the right reasons and in the right way. Also, I suppose I have a certain hard-won sense of being able to afford to do it.
Issues of abuse of power are, as I said, potentially present in any organization, including ones concerned with the psychoanalytic study of organizations. I can think of at least two group relations institutions where the leading figure would not retire in good time, which had stifling consequences. It is said that Ernest Jones had been in the job too long and that this contributed to the ëcontroversial discussionsí at the British Psycho-Analytical Society (King and Steiner, 1991). But the situation I want to examine in detail bears on a much wider and deeper framework. It is the culture of British psychoanalysis, including psychoanalytic psychotherapy. A situation has been developing in this subculture for some years which has, in my opinion, reached a level which seems to me to pose serious problems under the general heading: 'Physician, heal thyself!'
As Kenneth Eisold (1994) has shown, there is, regrettably, a considerable literature on the history of schisms in psychoanalysis. As far as I have been able to determine, however, much less has been written about the interface between psychoanalysis and psychoanalytic psychotherapy. This is, of course, partly a matter of definition. In Great Britain there is a convention that only members of the British Psycho-Analytical Society will call themselves psychoanalysts (although some Lacanians have taken to doing so lately). The rest of the psychoanalytic profession call themselves psychoanalytic psychotherapists, even though the work they do would be called psychoanalysis in many countries.
One of the features of my story which is most striking is not unique, but it feels so to people used to giving clinical examples without fear of contradiction, if only because the patient is not present, so the speaker has little to fear from potential alternative accounts. In the case of the British situation, there are a number of people who would whoop with profound disagreement over practically everything I shall say. (I will, of course, happily delete or alter any factual mistakes, and I assure you that I have gone to considerable lengths to check and re-check my facts.) Power lies with whoever get to define the situation. I believe that the most important conflicts over alternative accounts would occur along the following lines. Where I stress power, patronage and economics, they would emphasise standards, legitimate hierarchies and authority. Where I stress fair play, democratic process and natural justice, they would stress the letter of the constitution, people not being ready for full democracy and the slogan on the banner of all power brokers: 'The end justifies the means' (The motto of my publishing company was, by contrast, drawn from the reflections of Comrade Rubashov in Arthur Koestlerís novel, Darkness at Noon (1940), just before he is executed in a Stalinist purge: 'Only purity of means can justify the ends' - p. 207.)
Enough of preliminaries and mottoes. In the early 1970s there was a scare in Britain about Ron Hubbardís religious cult, Scientology (Miller, 1987). It has a rather interesting offshoot called Dianetics which purports to cure mental distress, and the legitimate psychotherapy organizations decided theyíd better get their house in order before the government did something draconian in the wake of what was called The Foster Report (1971; Sieghart, 1978). They set up The Rugby Conference which eventually transformed itself into the United Kingdom Standing Conference on Psychotherapy and in 1993 into the UK Council for Psychotherapy or UKCP. It is a tribute to the containment of all sorts of people that this inherently unstable conglomeration was held together for as long as it was. It contains eight sections: Analytical Psychology (Jungians); Behavioural and Cognitive Psychotherapy; Experiential Constructivist Therapies; Family, Marital, Sexual Therapies; Humanistic and Integrative Psychotherapy; Hypnotherapy; Psychoanalytic and Psychodynamic Psychotherapy; Psychoanalytically-based Therapy with Children. Special Members include the British Psychological Society and the Royal College of Psychiatrists (UKCP, 1995). The section which interests me is the psychoanalytic one which has, at present, twenty-eight member organisations.
In case you have not already guessed or heard, the problem which soon became apparent was whether or not the International Psychoanalytic Association psychoanalysts, i.e., The British Psycho-Analytical Society, would get into bed, first with the Jungians and then with the psychoanalytic psychotherapists (other sorts of psychotherapists have their own sections). I cannot tell you how many stories I heard about these negotiations and how many dreadful things I have heard various people called. One leading figure was routinely referred to as a used car salesman, another a sadist, another a bully, another a dupe or stooge. The behaviour and attitudes of the analysts have been referred to in my hearing as paternalistic, condescending, dishonest. (I need hardly say that there are epithets from the other side which are eat least as unflattering - see below.) Nevertheless, there were reasons for optimism until the psychoanalysts said that the price of their staying in was that their representatives should have a veto over the decisions of the council ó not the section, mind you, but the council of the whole organization. No kidding. They claimed to be senior to all other psychotherapeutic practitioners and referred to the device they advocated as ëthe Security Council modelí, after the body in the UN where any one of five countries has a veto and the Security Council can in some circumstances overrule General Assembly decisions. There are about three hundred members of the Institute of Psycho-analysis practising in Britain out of a total of about 2500 reputable and recognisably psychodynamic psychotherapists. (The present chairman of the UKCP tells me that there are about 3400 on the register at present and that he regards all of them as reputable.)
I should perhaps say at this point that I was not a member of any organisation for the greater part of these deliberations and am still not directly involved with the UKCP. I got interested when the training organisation where I was completing a postgraduate qualification conducted itself with respect to this matter in a way which I and others thought violated principles of democratic functioning inside the training organization, and this has, for the most part, remained my vantage point.
It would be possible to tell a very long tale about all this, but nobody has yet been willing to do so in print, and it would not serve my present purpose. A point was reached when the advocates of holding everything together were trying their utmost to give the analysts enough of a special status to keep them in, while retaining the principle of one vote for each organization in the UKCP. At that moment a person who was not a psychoanalyst but worked closely with them was not elected to a key committee, and the whole house of cards fell down. The representatives of the psychoanalysts and their allies decided that they 'had had enough'. A new and rival organization had been abuilding in the wings, and it was inaugurated. Only certain psychotherapy organizations were invited to join it. I will characterize them in a moment. The analysts withdrew, and the positions of several organizations close to them became very unstable because of divided loyalties. Practically all other psychoanalytic psychotherapy organizations which joined the newly-created British Confederation of Psychotherapists (BCP) remained in the UKCP, as well. It now has ten member organizations, with a lot of overlapping membership, e.g., analysts who work at the Tavistock Clinic or people who work there and are also members of the Association of Child Psychotherapists or any of the above who are members of the Association of Psychoanalytic Psychotherapists in the National Health Service (BCP, 1996).
Then some ironic things happened. It turned out that the representatives of the British Psycho-Analytical Society were behaving unconstitutionally in withdrawing without consulting the membership of the society. When they finally did, the debate and the vote were very one-sided, and they withdrew from the UKCP. I have the greatest respect for those who spoke in favour of staying in, but the greatly loved and admired President of the Institute was also president-designate of the breakaway organization, the BCP. Of those who spoke in favour of staying in the UKCP, one said that if they withdrew, it would be perceived in some quarters as a declaration of war on the rest of the profession. Another had worked inside the UKCP from the start and was not trusted by many analysts. Yet another edited a journal which sought to embrace all reputable psychotherapists.
The person who feared that the split would be seen as a declaration of war was proved right, and I will say more about the trench warfare which has ensued. What I want to say about the other organizations which broke away is contentious but the simple truth as far as I have been able to discern it. For the most part they kow-tow to the Institute of Psycho-Analysis. This is not true of the Jungians, but it is of the others. In particular - and I suggest that this is crucial - they insist that (with vanishingly rare exceptions) the people who are allowed to be training therapists in their psychotherapy trainings should be psychoanalysts. The same is true, although not quite to the same extent, of who can supervise and who gets asked to lecture and run seminars. Who can say how much we are looking at insistence on quality versus the maintenance of a patronage network and the hegemony of one organization over a number of others? One consequence of this situation is that the training organizations which are considered to make up the elite in psychoanalytic psychotherapy have the following feature. Their graduates never become faculty. Increasingly there are new rules being set up so that they can, in principle, do so, but none has in the three organizations I know about in detail, and it will be a very long time, indeed, before the majority of training therapists, supervisors and teachers are graduates of organizations other than the Institute of Psycho-Analysis. Thatís right. All the students and graduates are of one caste, and practically all the trainers and faculty are of another: therapists perpetually on one side, analysts on the other. In at least two organizations there are separate procedures for becoming members. Psychoanalysts do not have to jump through the same hoops as psychotherapists to become either members or training therapists. They are deemed to have fulfilled the criteria by virtue of being psychoanalysts. It was even argued at one point that their vitas should not be made available to the existing members when they apply for membership.
The organization to which I belong was withdrawn from the UKCP without it members, associate members or students being consulted. This was also true of a number of others. I have been told on good authority that of the ten groups who originally set up the BCP, five had to get the permission of their members and failed to get a majority of their members to agree. Five who left the UKCP did not have to get the permission of their members and did not seek it. The Professional Committee of my organization simply withdrew us, as they were legally (though I would say not morally) empowered to do by the constitution. A member then moved that we rejoin. A member of the Professional Committee who had been active in setting up the BCP tried to get the motion ruled out of order but failed. Then there was a debate set up by the Professional Committee with arguments on all sides and a speech from a visitor from the other of the two most highly-regarded psychotherapy trainings, beseeching the organization to rejoin. There was - unaccountably - no vote taken on the evening of the debate. There was then a postal ballot conducted by a senior member. Two thirds of those voting chose to rejoin. This was ignored by the Professional Committee, which was chaired by someone who was well-known to be strongly partisan toward the BCP, had one of the BCP's founders on it and had others who were analysts and still others who had strong reasons for being deferential to the analysts. Then a postal ballot was held by the Professional Committee. A majority voted to re-join. Then the Professional Committee said, sorry, we should have included the students: vote again. Again the vote was in favour of re-joining. At the next annual general meeting the Chair (who was retiring that day) announced that the Professional Committee had decided not to act on the vote. He declared the majority insufficiently large. Fifty-nine per cent of those voting were in favour This is a novel electoral principle, donít you think? How many national elections involve larger majorities? He also ruled that no discussion of this matter was to be allowed at the meeting. This act of consummate arrogance was his last official ruling as Chair of the Professional Committee, and it was immediately followed by a farewell drink in his honour. I am sorry to say that I did not feel able to honour someone who I thought had just behaved dishonourably. He had, in my opinion, shown breathtaking contempt throughout the entire controversy over this matter, both with respect to democratic process and to democratic decision-making.
For a technical/legal reason that AGM had to be re-held. The matter was put on the agenda. It was moved that the organization rejoin the UKCP without further delay. The thought behind the motion was that we should take our seat in the parliament of our profession and, if, for example, we thought standards of training inadequate in some organizations, we should argue for the standards in which we believed. An analyst who was also a senior teaching officer and who had a reputation among UKCP delegates for being particularly nasty, spoke vehemently against the motion and said all people who were not in the BCP should be prohibited from calling themselves psychotherapists, because, as he put it, they were 'charlatans'. He referred to the stance of the other most-respected psychotherapy training to remain in both organizations as (I quote) a 'Vichy policy'. I have thought a lot about this vivid and violently contemptuous phrase. On the surface it implies an analogy between those who want to hold dual membership in the UKCP and the BCP, on the one hand, and the collaborationist French regime of the traitor Marshall Petain which governed in collusion with the Nazis, on the other. Viewed in terms of what may be being unconsciously projected, the analyst who said it could have been disowning an impulse to defer to and govern on behalf of a cruel and sadistic, dominant and authoritarian regime, one which committed genocide. Note that the pluralistic and (some would say excessively) democratic UKCP is treated as like the Hitler regime, while the elitist and high-handed BCP is treated as like the embattled and brave Gaullist Resistance, whose sacred symbol was the Cross of Lorraine. Calling all non-members of the BCP 'charlatans' also invites interpretation of the speaker's contempt - perhaps for himself. Another person - not a psychoanalyst - had said in an earlier debate on this subject that since we psychotherapists owe so much to the psychoanalysts, it would be 'ungrateful' to make a decision with which they might disagree. This sort of language reminds me of Kenneth Eisoldís (1994) reflections on intolerance in psychoanalytic organizations and members' contempt for outsiders. His analysis is silent about those on the receiving end of the contempt.
Before the meeting where rejoining was being debated, teaching officers telephoned students. I know of at least one who felt she was being lobbied. The teaching officer who phoned urged her to vote and informed her that she could give her proxy to someone if she didnít wish to attend. Another teaching officer said to her at the meeting that she hoped the student wouldnít be voting to re-join the UKCP. My informant is a feisty woman. I cannot say how others responded to this sort of pressure. The new Chair of the Professional Committee had been working closely with the previous Chair in another context for many years but (because of disaffection with aspects of how the training was being run) had not been active in the training organisation for some time until it seemed that a pro-UKCP person might become Chair. He suddenly reappeared (I knew several members who had never heard of him or seen him at a meeting) and was put forward as a candidate and got elected. He got up and spoke passionately in the debate about rejoining the UKCP and said he would be voting for staying out. Donít forget: these are the people who decide if a student qualifies. The vote - the fourth one - was two-thirds in favour of staying out of the UKCP, an exact reversal of the first vote, which had been two thirds in favour. It has, of course, been declared definitive. If at first you don't succeed... (An official investigation into some aspects of possible undue influence on voting found no evidence of proxies having been obtained by inappropriate means.)
One of the arguments most strongly put on this occasion was that it was not going to be allowed for an organization to belong to both the UKCP and the BCP. The implication was that to rejoin the UKCP would endanger membership in the more prestigious BCP. In fact, since then three of the largest and most prestigious member organizations of the BCP have, nevertheless, voted to retain dual membership, and one has said that if they are forced to a choice, they will, albeit reluctantly, allow themselves to be expelled from the BCP rather than resign from the UKCP. The organization closest to ours has also voted to stay in the UKCP, but the BCP has ruled that this is not going to be allowed (never mind that the Jungians and the Association of Child Psychotherapists are determined to do just that). Therefore, notwithstanding the recent majority in favour of staying in, their Council are under terrific pressure to withdraw or have another vote in which they will have to choose between the elite BCP and the other and more broadly-based organization, the UKCP. When it was objected that they had already and very recently voted to remain in both, a council member said not to worry about that; another organization (mine) had to vote four times before they got it right... I was told that the people in favour of staying in the UKCP 'are being slaughtered'. On reflection, this phrase was modified to the observation that they were being subjected to unremitting pressure to change their minds. Indeed, the Chair of the BCP is chair of that training organizationís most powerful training committee, and it is said to be hard to be on that committee while opposing her in this matter. It appears that the Association of Child Psychotherapists will be allowed to be an exception and to hold dual membership, and there are rumours that the Jungians may be cut adrift - so determined are the analysts to retain their hegemony over the 'top end' of the psychotherapy profession and set it apart form the majority of practitioners of psychoanalytic psychotherapy.
This saga continues. Several months after I first delivered this paper I was told that when this organization voted by secret ballot to retain dual membership, a code was put on the ballots to indicate whether the voter was a member of the Freudian or the Jungian part of the organization. When it was discovered that a greater percentage of the Jungians voted to remain in the UKCP than the Freudians had, a new strategy was set in motion: to change the structure of the organization into a confederation, with the Jungians and Freudians deciding separately on the question of dual membership. The result being sought by those advocating this restructuring would be that the Freudians would withdraw from the UKCP and the Jungians stay in. You could say that this is a sensible way of allowing the respective majorities to have what they want, but you could also say that the divisiveness and teeth-clinching determination of the BCP to have its way is in danger of fostering a split in an organization which had hitherto and admirably admirably kept Freudians and Jungians in a close working affiliation. The net effect of the proposed restructuring would be, at best, a looser affiliation, and there is no doubt that the effect of the BCP's policy is interference in the internal affairs of this organization in a way which fosters splitting and is causing severe distress. An Extraordinary General Meeting was called to consider this proposal. However Machiavellian this scheme may appear, it was considered to be a compromise. At one stage after the vote to retain dual membership, the BAP Council voted seven to four to withdraw from the UKCP without any further vote by the membership. The four members of the minority walked out, and a scandal was threatened. The confederation idea was designed to head off this outcome. In the period just before the meeting the photocopiers hummed, and at the event there was a large majority against even voting on the question of single membership, a significant one against giving the council a mandate to decide and a strong vote to set up a working party to consider lines of authority between the membership and the council. In short, the membership were very cross with the council. One point which finally became very clear during this debate is that, notwithstanding all their intransigent assertions, the BCP policy of insisting on single membership is not written in stone anywhere, and its member organizations should be able to consider alternatives, something the Jungian Society for Analytical Psychology has taken the lead in doing.
At the time of writing, all dual membership organizations have decided to retain dual membership, and more than half of those on the BCP register belong to those organizations. This means that the BCP has a problem of democracy of its own, since the majority of its individual members belong to organizations which have voted to retain dual membership. One of the objections the BCP makes to the constitution of the UKCP is that it allows its member organizations to have a democratic vote in its affairs instead of leaving everything to the executive committe or council, as the BCP does. To carry out its policy of sticking to single membership it is crucial for the BCP to win its battle with the BAP. They can make special dispensations for the Association of Child Psychoherapists and for the Tavistocl Clinic, citing grounds which are supposed not to apply to other BCP member organizations. They can also survive the loss of the Jungians, but they cannot survive the expulsion of the BAP, the largest member organization in the BCP. There are several other organizations contemplating BCP membership. Allowing the BAP to retain dual membership would act as a precedent for all of them, thus unravelling the basic aim of keeping the BCP under the hegemony of the Institute of Psycho-Analysis. I should add that the current Chair of the BAP is a psychoanalyst, who has been quoted as holding the view that dual membership is untenable. If so, why are other organizations being allowed to have it?
I am struck by the degree of deference apparent in the voting patterns of a large minority of the psychotherapists. They infantilise and subordinate themselves in order to be allowed to be near the mandarin analysts who continue to keep them from dining at the high table. I want to say candidly at this point that I find it impossible to separate arguments about standards from the ones about power and patronage I have been stressing. It has rightly been said that it is not obvious that one can be sure about meeting standards in training psychotherapists, since one is attempting to measure the human heart. One can have requirements, however, and the received wisdom is that ëmore means betterí. Analysts go for five times a week, the elite organizations recommend that but accept three, and those further down the pecking order accept as little as one or two sessions per week for training therapy and for supervised training cases. Some argue, on the contrary, that five times per week is easier than once or twice per week. As it happens, I'm an elitist about times per week, but I teach somewhere where this is unrealistic, so we recommend more times per week but accept less. I want to add that I think that something can be a legitimate requirement but at the same time can still serve as a rationalisation for baser motives. One comes across this in patientsí material all the time. I think these matters cannot be easily untangled, but I should report that the BCP says in its self-description that certain organizations began to meet in 1992 because 'they were concerned that the diversity of standards and trainings and the size of the [psychoanalytic and psychodynamic] section... posed insuperable problems to the establishment of appropriately rigorous standards of training at all levels'. Stay in and fight for the highest standards, I say, and donít assume that those with whom you disagree have no standards or have contemptible ones.
There are parallels between what I have related and the American situation. Some years ago a court case was brought by some lay psychotherapists, and the American Psychoanalytic Association (APA) is now legally obliged to accept people for training who are not medically qualified. The approach which won the day in an out of court settlement was that the APA was acting ëin restraint of tradeí in preventing them from becoming psychoanalysts. In Britain an approach is currently being made to the Office of Fair Trading along similar lines. I gather that in the wake of the American court case, efforts were made to join the International Psychoanalytical Association (IPA) by organizations where training therapy and training cases are conducted less than five times per week (as they are in a number of other IPA-affiliated organizations in other countries). These approaches were declined by the APA. Moreover, in the recent and hotly-contested election for a new President of the IPA, one candidate stressed the importance of maintaining the distinction between psychoanalysis and psychotherapy, notwithstanding the fact that most analysts see people less than five times per week for most of their practices. He also recommended (if I understood his campaign manifesto correctly) that analysts should start and have control over psychotherapy trainings. The losing candidate argued for more democracy and accountability and more access to the decision-making process in the IPA. Four out of the five living ex-Presidents of the IPA came out publicly in favour of the more conservative candidate, and he won by a modest majority. I particularly recall seeing a letter by one ex-president of the IPA regarding confidentiality. He argued strongly that council members of the IPA should under no circumstances discuss any council business with anyone who is not a member of the council. It is as if the confidentiality appropriate to the analyst-patient relationship is obviously also appropriate to governing committees
That rang a bell with me. I was on the College Council of King's College, Cambridge, throughout the politically fraught period of the late 1960s and was acutely aware of problems of confidentiality. As Tutor for Graduate Students I had inherited a number of American would-be revolutionaries whose universities one suspected may have been glad to give them scholarships to go abroad. The College's position was that its teaching officers had to use their own discretion about confidentiality and adhere to the spirit rather than the letter of the boundary, since it was essential that they mediate between the college authorities and the disaffected students. We managed this quite well, as I recall the period. I think the arguments which applied in that context would apply with greater force when the council members were representing fully-qualified professionals and trainees most of whom were already established in core professions. No one denies, of course, that there are areas where very strict confidentiality is appropriate. I tell this anecdote, because it helps me to see that what we are dealing with in these matters touches on general political and social attitudes of an open vs. closed and left-right kind. I think the BCP is closed and right wing and the UKCP is open and liberal.
I do not mean to imply by this that the UKCP stalwarts always behave well. I was responsible for staging the first public debate on ths matter. There were ructions, but the issues were well-aired, and I published the talks given on all sides of the issue (Free Associations No. 29). When I tried recently to get the same organization to stage debate about the current situation, the proposal was blocked by a UKCP apparatchik, saying that the matter was being well looked after behind the scenes by him and two others and that a public debate should not occur in the present situation. This decision was later reconsidered, and the debate was held. In the interim I proposed that there be a public debate at a conference on 'Psychoanalysis and the Public Sphere'. (I am a member of the panning committee.) We wrote to the BCP and proposed the idea. The answer was that the time alloted to them in the debate was not sufficient. I spoke to the Chair of the BCP, saying that we would be prepared to make practically any changes in the format of the debate if they would take part. She seemed amenable and took the matter back to her committee, but after discussion they declined to take part in the debate under any arrangements. Public debate and accountability are of the essence of democracy. By not being willing to take part in public debate the BCP lends credence to the conclusion that they are interested in hegemony attained by whatever means necessary and not in democracy. My attempts to engage their public relations officer in discussion have also come to nothing.
You may by now be wondering what it is in this saga which is of interest to students of the psychoanalytic study of organizations. It is this. I believe that the people in my organization who were and are partisans of the BCP have behaved wrongly, by which I certainly mean undemocratically and contrary to natural justice. I also mean that they have behaved in an authoritarian way, one which is characteristic of certain training organizations in Britain and (I am told) of the American Psychoanalytic Association and the International Psychoanalytic Association. In some instances I believe that they have been manipulative and deceitful and have refused to be accountable. You may say, 'It was ever so.' Indeed, a person whom I greatly esteem said to me of my attempts to engender debate on this matter, 'All institutions are corrupt. Everyone behaves badly. You will get nowhere trying to change things by taking up the high moral ground'. He backed this approach in practice. I submitted an article ('The Culture of British Psychoanalysis') which touched on these matters, though only in part, to a journal he edited. I did not wish to publish it in my own journal, since I didnít want it said that I had influenced the refereeing of it. He rang me and said that the referees had recommended publishing it, subject to some minor changes, which I would have made willingly. He then said that he wanted me to know that no matter what changes I made he would never publish it, because it contained criticisms of the Institute of Psycho-Analysis which he was not prepared to have published in his journal. Candid, straightforward.
Of course, there is plenty of literature about how badly and often madly important people behave. Having grown up among such people in Dallas, e.g., the oil tycoon, H. L. Hunt (Hurt. 1981), after whom the father of JR in the television series íDallasí was modelled, I am something of a connoisseur of their biographies and the organisations which they run. I am thinking, for example of books about F. W. Taylor, the founder of scientific management (Kakar, 1970); Henry Ford (Sward, 1948; Herndon, 1970; Jardim, 1970); the founders of IBM and ITT; Howard Hughes (Drosnin, 1985); William Randolph Hearst; Huey Long (Williams, 1969); Richard Nixon (Rangell, 1980); Rupert Murdoch and Robert Maxwell (Bower, 1995). Hollywood tycoons loom large in this genre, as told in Indecent Exposure (McClintick, 1982), The Final Cut (Bach, 1985) and in Youíll Never Eat Lunch in this Town Again (Phillips, 1991). The same can be said of clearly pathological cult leaders, e.g., the Bhagwan (Milne, 1986), Rev. Jones, Charles Manson (Bugliosi, 1974), David Koresh and the recent ones in Canada, Switzerland and Japan. The most meticulous biographical studies of people who behave with consummate ruthlessness are Robert Caroís Pulitzer Prize-winning volumes, The Power Broker (1974), a life of the czar of New York public works, Robert Moses, and his The Years of Lyndon Johnson (1983, 1990, the last volume of which has yet to appear).
I think the Kleinian psychoanalyst, Donald Meltzer, has shed a flood of light on the psychopathology of certain leaders of organizations in his book entitled The Claustrum (1992), in which he describes the personality type of people who absolutely have to win, people who are truly, madly deeply competitive and ruthless. He argues that in their internal worlds they live at the very end of the line of the psychic digestive tract, the claustrum, just inside the anus, and are in the grip of perpetual, acute and highly-motivating psychotic anxieties about the prospect of being expelled into the external world, thus precipitating a schizophrenic breakdown. Their desperate acts are in the service of avoiding this fate. Now we have a psychoanalytic theory for What Makes Sammy Run (or made Gordon Gecko run in the film ëWall Streetí), where before we only had a narrative. Meltzer (1986) hates institutions and opines that this way of behaving is characteristic of high-achieving, ambitious leaders. I want to draw up short of the most general form of this baleful conclusion. I believe that there are some decent big shots to set alongside Meltzers assholes (Abraham Lincoln and Nelson Mandela come to mind: hence my edication of this book to them), although I have to say that the history of my experience of various sorts of institutions from high school and university and medical school and teaching in a university department and on to political agitation, making documentaries for television and publishing books and journals has not given me many grounds for optimism. I confess that one reason I looked forward to becoming a psychotherapist was that I believed that its subculture would provide a haven from such behaviour. I had not anticipated finding this personality type in the world of psychoanalysis and psychotherapy, but I am here publicly repenting my naiveté.
What has distressed and puzzled me most - to the point of often not being able to think - is a situation in which the normal vicissitudes of power are linked to two highly-coercive and mind-boggling factors. The people in the UKCP/BCP story claim with utter conviction that they are defending the holy of holies of integrity in psychoanalysis. This way of thinking was, of course, the justification for the Spanish Inquisition, the Salem witch trials, the Stalinist purge trials and the Gulag Archipelago, McCarthyism, Trotskyist and other sectarian schisms and Pol Pot's genocide in Cambodia. I could go on. It is my experience that when a person believes himself to have a pipeline to truth, true communism, the unconscious or to God, one can kill and maim and belittle and expel others in a higher cause. The higher the cause, the more licence to kill one has, as Ian Flemingís secret agent, James Bond exemplifies with his 007 badge. It is also my experience that some people with capacious spirits need not and do not behave in this way. It has struck me that the people who have been most intolerant in the BCP are not themselves, and in many cases are not likely to become, training analysts in the Institute of Psycho-Analysis. I grew up in a part of the world where the rednecks were mighty glad to have another group of people lower than them on the totem pole, over whom they could lord it. Indeed, a leading BCP partisan once said of the resistance to his rulings, 'The Blacks are getting restless'.
So, my first mind-boggling factor is behaving badly in the name of preserving the good. The second one is having people by the short hairs, by which I mean that there are many threads in all this which take us from the power broker to the vulnerable and unconscious parts of the constituents. The analysts analyse and supervise the psychotherapists. They decide if and when they are ready to see training patients and eventually to qualify. They do or don't make referrals of patients to them. They do or donít appoint them to positions as honorary therapists in the hospitals where the analysts control practically all the consultant posts in psychotherapy. (I once saw a letter in which the writer, a psychoanalyst, was expressing distress that a person who was neither a psychoanalyst nor a Jungian analyst had been appointed to one of these coveted consultant posts, arguing how important it was to ensure in future that only one or the other of these types is appointed to such positions.)
I donít think I can trace the links in detail, not because I have no data but because people would be precisely and individually identifiable. Instead, I will trace the sorts of links involved, for example, members of committees who are or have been in analysis with important BCP apparatchiks or mentors. I believe that the transference never ends, and these links have cut both ways. People are applying for jobs with BCP stalwarts. In one striking case, a voter on a key committee was an applicant to the Institute (a successful one, as it turned out); in another an applicant for a plum academic appointment steered clear of the controversy altogether. He got the job. My position does not depend, however, on such direct and obvious causal connections. It is just as important that mandarins are taking up a position and sub-mandarins and would-be mandarins are voting - or perhaps I should say deference voting. Anyone who went to medical school will easily recall how medical students and junior doctors unconsciously take up the mannerisms and social attitudes of the professors and consultants. If this is so in the medical hierarchy, it is even more likely to be so where analyst-patient, supervisor-patient and patron-protégé relationships are involved.
I want to draw attention to an obvious but treacherous elision. As I said at the very beginning of this essay, people become teaching officers and members of the main governing committees of organizations by virtue of being well thought of. This is trivially and obviously true and perfectly appropriate. In most organizations their auras carry weight when they are in leadership roles and in their roles on key committees. This is also appropriate. But in certain organizations - religious, political and psychoanalytic - there is an extra charge on their authority. They are not merely respected and perhaps wise. They are also objects (in the sense of object relations theory) at the centre of the unconscious processes of their analysands, supervisees, tutorial students. They are not only an object; they are, in the case of analysands, the object and in the case of supervisees and training committee members something very near to that. (I suggest, by the way, that this aspect of object relations theory could bear important fruits in the study of other sorts of organizations.) This is not only the case from the point of view of the analysand/ supervisee/ student. The training analyst/ therapist/ supervisor/ teacher is accustomed to having superior clinical insights and holding on to them in the teeth of passionately felt resistance which can be held onto for a long time. They become accustomed to weathering all onslaughts from the resistant and dependent person in their charge.
This attitude carries over into organizations, and the senior person may easily come to feel damned-near infallible and may come to treat all disagreement as symptomatic. I have seen this repeatedly in psychotherapeutic training organizations. I have seen a senior teaching officer convey baldly that she was all that stood between the pathological narcissism of the students and chaos. This attitude is not only held by individuals; it seems to be characteristic of analysts as a group with respect to psychotherapists as a group. As I mentioned earlier, I heard an analyst in a heated debate on the question of criteria for making people be training therapists say, quite baldly, ëAnalysts are our only guaranteeí. Similarly, as I've said, at a crucial point in the debate about allowing the psychoanalysts to have a veto over all decisions made in the UKCP, an analyst said that refusal to grant this would be like 'allowing the students to set their own exams'. The implication was that analysts are all in the teacher grade, while psychotherapists are all in the student grade. The accountability only goes one way; the hierarchy is assumed.
We have here a group which sees itself as a mandarinate, a caste of Platonic Guardians of the Ideals of the Good, the True and the Beautiful. The representatives of this caste very easily pathologise those who disagree with them. They do more. They threaten them with legal action for bringing their motives in this debate into doubt. I once wrote what I intended as a summary of the history of the debate in order to introduce published papers on various sides of the issue to an international readership. I referred to a leading figure in the debate as a leading figure in the debate. I showed him my draft. He wrote back that I was in danger of defaming him by suggesting that he had played this role. I did more research and found ample justification for the claim, including the fact that at a meeting of an organisation of which he was chair of the main committee, he had begun the crucial meeting saying that heíd keep them there until they voted the right way. They didnít: they voted to stay in the UKCP. I took legal advice; I printed the truth as best I could express it. The next time I saw him, I asked how he was doing (he had recently changed jobs). He asked if I really wanted to know or only asked so that I could write 'something else scurrilous' about him. (I had not named him there and do not do so here.) The dictionary defines scurrilous as ëgrossly or indecently abusiveí. In another context I spoke of his bullying tactics and was taken aside by a former supervisee of his, saying that he had taught her a lot and that she did not like to hear ill spoken of him. When I said these were political disagreements and that I had no criticisms of his work as a supervisor, she said that to speak about him critically felt scurrilous to her. I call this paranoid-schizoid thinking. For someone who is in the paranoid-schizoid position, it is unthinkable that revered supervisors could behave badly in some other role and be legitimately subject to criticism and political and moral accountability.
In fact, of course, people are mixtures; that is what the concept of the depressive position tells us. They behave well in some contexts, less well in others, badly in others. In psychoanalytic organisations, as Kenneth Eisold has helpfully shown, dissent is not tolerated. There seems to be no space for genuine and open political debate and uncertainty. Here is an instance. Members of my cohort in a highly-regarded postgraduate psychotherapy training stood up to the powers that be. We did this with respect to various matters about training standards and being treated as adults. Without any hint of difficulties before that day, we were told that a majority of us would have to train for longer than weíd been led to expect and until the doubts about our competence were resolved by further supervision. We can, I hope, be forgiven for noticing that the small number who were to qualify on time were, aside from their undoubted abilities, goody two-shoes. We remonstrated. We had been told that we were their best group ever. I had been given their prize the previous year. We were now being told that a certain supervisor whom we liked and admired was our severest critic. This was stunning. On the evening of the meeting we had finally managed to get the senior teaching officer to have with us to try to sort this matter out, someone suggested I phone and ask this allegedly severest critic what heíd said. I did, and he replied that heíd made criticisms but that if anyone was not being allowed to qualify on time because of anything he had said, he was íbeing used as a scapegoatí. When his supposed criticism of the group was repeated in the showdown meeting, I quoted what he had said to me not a half hour earlier. I was removed from the group. (I eventually came to the conclusion that his criticisms were, in part, bound up with his loyalty to the other most highly-regarded training organisation, in which he was an active teacher. Our kids couldn't be better than their kids.)
The Chair - he of the UKCP/BCP cufuffle - met with me and said that he guaranteed I would qualify if I would agree to leave the seminar and have supervision with someone new for three months until things cooled down. I went away to think about it and spoke to the designated new supervisor, whom I came to regard as a benign probation officer. He said that I had not been told the whole truth: the likelihood was that I was going to qualify but not be made a member. This cunning little move was inconsistent with the organization's own publicity, which stated simply that completing the training led to membership. I was shocked by this deceit and made a bigger fuss, including strong backing from my supervisors, who had also been grossly misquoted. The supervisor who took the strongest line (an eminent and very senior training analyst and former director of the Institute's clinic, who has since been made head of another prestigious psychotherapy training) was dropped from the programme. Near the end of the probation period my parole officer said that they knew they were in the wrong and that all would be well if I would ëonly be forgiving for a few weeks longerí, a phrase which made me feel utterly vindicated. I kept my own counsel; there was a vote in which the mendacious teaching officer tried her utmost to prevent my being made a member, but she was outvoted. In spite of these and a number of other matters where students felt unfairly treated, she remained in office for some time and was able to arrange things so that a like-minded person (and vehemently outspoken opponent of the UKCP) became her successor. This dismayed a number of members and occurred without widespread soundings being made in the organization. I tell this story (messy as it is, like all properly accurate real-life narratives) to drive home my earlier point that people are mixtures. This means that their clinical and other merits are likely to be intermingled with other traits of character and political and social attitudes which are no better and may be worse that those of other professional people. The person who behaved so badly in that episode had been an excellent supervisor for me for a considerable time and had invited me to join the postgraduate training programme at a time when I had no inclination to contemplate further training.
The problem posed by the psychodynamics of psychoanalytic (and religious and political) organizations is how to structure their governance so that the legitimate reasons for making people teaching officers and members of governing committees should not be over-generalised and idealised. It is appropriate that they should be subject to the assessments of character and the checks and balances and forms of accountability of the democratic political processes which apply in other settings. Moreover, attempts to designate a group of highly-qualified psychoanalytic (or religious or political) practitioners as superior by virtue of having particular qualifications and then place them over the rest of the profession is a breathtaking usurpation. For them to object to people not allowing that they constitute a 'Security Council' and then to set up a breakaway organisation whose main structural features are keeping organisations out which donít kow-tow to them and declaring all other practitioners of an inferior caste (or perhaps even charlatans) is clearly and simply a power play and should be transcended. That is, we must find a way of going beyond the present situation. However, in order to achieve this healthy iconoclasm, we have to unscramble the self-infantilisation and deference of the organisations whose members have allowed it to happen. That may be harder. Mandarinates trade on the low self-esteem of ordinary people, even and especially ordinary people who express their ordinariness in being good and non-self-idealising psychotherapists, priests or politicians. I am sorry to feel constrasined to add that few people in power do not give it up willingly; it almost always has to be removed from them in the teeth of determined opposition.
We are left with some questions which are unfamiliar to psychoanalytic discourse. Why do the leaders - as distinct from the followers, patients and supervisees - behave badly? Why aren't they stopped? Why is it so hard to take account of issues of power, patronage and economics? Why, when we do, can we not provide an account which integrates such matters with those of individual and group unconscious dynamics? (This is also, in my experience, a serious problem at group relations conferences.) Why cannot we grant that a critic, including me, may have some neurotic motives and still be right about the behaviour of those being criticised and about the issues involved? A colleague whose knowledge of group relations is nonpareil and who read an early draft of this paper said that I was sure to be pathologised but that he was also sure I was right and right to bear witness. Another - also of high standing - wondered aloud about the risk of being had up for libel. In the politics of the professional world, though not the world of the politics of legislatures, matters of this kind tend not to be publicly discussed until the protagonists are dead.
One way of describing the psychodynamics involved in my story is as a social process of projective identification. The analysts (with the special enthusiasm of those who are not likely to become training analysts), as an institutionalised group, project their contempt and uncertainty about their true status and abilities onto the rest of the psychoanalytic profession. (I was told that one had played tennis regularly with someone else until one day that beat him. After that, although they belonged to the same club, the one who had always won up to that point never spoke to the other again.) They elicit uncertainty and low self-esteem from the BCP psychotherapists - or, at least, from their 'collaborators' in the designated organizations. The psychotherapists, in the moment of identification, re-project the uncertainty in the form of deference voting and renounce all claim to the status of training therapist or supervisor, a vision of the future with no Oedipal triumph in view. The door to changing this is ajar, but the passage is narrow and change will be very slow. This is an aspect of my story where the economic self-interest of the psychoanalysts is all too apparent. I have even heard it said that five times per week analysis is becoming unusual, except for candidates in training, so it is jolly useful to have a captive clientele.
This caste relationship becomes institutionalised in the BCP/UKCP split. Those who oppose this way of seeing the culture of British psychoanalysis are then subjected to put downs and pathologization and are out-manoeuvred or otherwise manipulated by any means necessary - all in the name of standards and purity. As the analysts put it at a recent British conference on the relationship between psychoanalysis and psychotherapy (and as it was put by another in an internal memorandum describing their proposed programme in psychoanalytic studies), they represent 'the gold standard'; the therapists are alloys and baser metals - copper, as I recall one saying. How are we to attain the depressive position in this matter?
(Place of publication is London unless otherwise specified.)
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