TO BEGIN AT THE BEGINNING
The tale of personal or psychological therapy, which is also the tale of psychotherapy and the tale of counselling, is as old as the story of the human race (Cushman, 1990; Hollanders, 2000a). Humans have long tried to make sense of themselves and their worlds (Bettleheim, 1983). That is why people have always used therapists, be they priests, gurus, wise ones, philosophers, doctors, good friends, or in fact just about anybody prepared to listen, as sounding boards and as guides to help to try to bring some order into their inner and outer worlds. In other words, the role of the talking therapist goes back to the dawn of humanity (Ehrenwald, 1976). However, in terms of what we today would recognise as the discrete dis-cipline (or disciplines) of counselling and psychotherapy, it is probably the profession’s developmental history over the last 100 years or so that interests us most (Freedheim, 1992). Of course, personal therapy has come a long way since its early days.
However, before we get too far into exploring therapy’s story, let us clear up one important source of confusion. There are many terms used to describe professionals who get involved with helping people who have emotional, psychological or mental health problems. Titles such as counsellor, psycho-therapist, psychological therapist, psychoanalyst, psychologist and so on are all used, sometimes apparently at random. Naturally, people are often puzzled about how to understand the differences between all these professionals. The practical reality is that, historically, these different titles have probably owed more to the inbuilt prejudices learned during early therapeutic training than they do to actual differences in professionalpractice. After all, many authors (Duncan et al., 1992; Fiedler, 1950; Wosket, 1999, etc.) give us reason to suppose that experienced therapists are far less worried about therapeutic style-boundaries than are the less experienced practitioners. Therefore, the answer to the ‘what’s in a name’ puzzle (as far as this book is concerned anyway) is simple: there are NO differences. If you are a professional – and that includes all the personal therapists – who is trying to help somebody with emotional, personal or mental health problems, then you are a psychological therapist and practising what today are often called the talking therapies. Of course, in these more enlightened times these therapies increasingly include a lot more treatment methods than just ‘talking the talk’. Today’s psychological therapists work with action therapies, treatment plans, practical activities, psycho-education and many other interventions; they ‘walk the walk’ as well. In other words, today at least, the choice of which professional therapist title to use to describe your practice is yours to make. However, it is very important to note that the current (July 2009) proposals to officially regulate counsellors and psychotherapists may result in these two callings becoming separately registered. This might happen perhaps from about 2014–15 onwards and may possibly even involve different levels of training. Nevertheless, in this book, all the talking therapy titles will still be used interchangeably.
There is one important exemption to the blanket definition of psycho-logical therapist (or any other title that you prefer) that was given above. It is an iron-clad rule that all psychiatrists must be qualified medical practitioners. Psychiatrists are doctors who sometimes prescribe medical treatment for those suffering from mental distress. Therefore, their pro-fessional title is legally protected. It is theirs alone. However, having said that, wise counsellors and psychotherapists will not allow the high-level professional status enjoyed by psychiatrists to lead them into automatically awarding superior professional status to the medically qualified. Psychia-trists are our respected colleagues and valued co-workers at the psycho-logical coalface; they are not the mine owners.
Whatever we call them (counsellors, psychotherapists or any name you like), what we really need to know is: What is it that they actually do? Well, that is a tale that is long in the telling. This book will give you one takes on the therapy story. Perhaps by the end of this book you might have some stories of your own to tell about the psychological therapies.
So, let us think again about the core question that this book will be exploring. What indeed are counsellors and psychotherapists for? What do they do? Do they really sort out people’s minds? Surely treating the mad is a job for doctors? Well, historically that might have often been true (except, of course, when the priests claimed their share of the action!). However, we will begin our exploration of counselling’s story by considering how madness has been viewed throughout history.