Politics, ethics, regulation and the talking therapies : current positions emerging from Parliamentary debate

by Julia Evans on November 20, 2013

Thank you Andrew Samuels for circulating this article:

Abhorrent ‘cure’ for homosexuality will not be banned, says Government minister.

Psychotherapists trying to convert gay patients to hetrosexuality is “wholly abhorrent” a Health Minister told MPs today : By Owen Bennett – Political Reporter : Published Daily Express : Wed, November 20, 2013 : available here 

Andrew points to the regulation aspects of this piece. I found it provoked much thought.

1) Is the outlawing of conversion therapy by the state, possible without the enshrining in law that attempting to change someone’s sexual preference is absolutely wrong?  So if a subject chooses to change their sexual preference, whilst consulting a therapist, then the therapist is at fault?

2) Practitioner ethics : What is the position of a practitioner? 1. To impose a ‘better’ way of living, for example, by getting the subject into paid employment? 2. To produce a superior human being who understands themselves, probably to the level of the practitioner? 3. To direct the treatment according to hypotheses the practitioner puts together from what the subject states? I suspect that conversion therapy and the Government-supported Wellbeing Clinics work at level 1.

3) Politics: How much of their subjects’ behaviour should the state regulate? Is it possible to be on the miserable end of the Government’s happiness scale, and still be up to the Government standard for human beings?

Points from the article:

  • Labour MP Sandra Osborne called a special debate in Westminster Hall in which she urged ministers to impose regulation on the psychotherapy sector.

She claimed conversion therapy was “extremely harmful” to patients and during the debate other MPs labelled the practice as “voodoo”. 

MPs are concerned NHS GPs are referring people struggling to accept their sexual orientation for conversion
  • Ms Osborne said: “Virtually every major national and international professional organisation has condemned this practice as ineffective and potentially extremely harmful to patients.”

She added: “This is more than just a problem amongst religious fundamentalists, it’s an issue for the NHS and professional sector.

 Ms Osborne continued: “We also need to ensure that psychotherapists who aren’t members of professional bodies which explicitly have positions against conversion therapy, are not commissioned by the NHS.”
  • Currently in the UK there is no minimum level of qualification that needs to be reached in order to practice as a psychotherapist, meaning anyone can set themselves up as a counsellor.
  • Ms Osborne argued introducing regulation into the profession would make it easier to stop conversion therapy being carried out.
  • Mr Lamb began his response by saying: “I find this practice wholly abhorrent and it has no place in a modern society.”

 He said: “It is completely inappropriate for any GP to be referring a patient for this sort of therapy.

” The Government are not aware the NHS commissions this type of therapy.”
  • He added: “The Government believe state regulation will not be appropriate, as the cost of registration for therapists and for the taxpayer could not be justified.”
  • Core Issues (which supports conversion therapy) spokesman Dr Mike Davidson said any moves to ban conversion therapy would be an “affront” to individual freedoms.
  • He urged MPs to vote against a Private Members Bill set to be debated in Parliament in January which would lead to regulation of the counselling sector.
  • “We call on the government to ratify evidence-based scientific data, rather than to promote political ideology which exploits and uses people who understand themselves to be homosexual, for its own ends.”

Questions to be asked:

– How much should a Government protect individuals from harm? (Ms Osbourne’s allegation is that it is possible for a therapist to harm an individual during conversion therapy) She then generalises her argument to state that to ensure no conversion therapist can effect harm, then all talking therapists have to be registered. So she is generalising from one example to ALL therapies.  & this is an acceptable level of argument in our Parliament.

– Ms Osbourne then argues for a blanket exclusion of those whose registering body is not up to her ONE standard.  As she is arguing for THE Good, she must be Right or on the side of Angels – As Ms Osbourne clearly considers she is a member, if not founding member, of this exclusive club THE Good, I propose that all Angels have automatic membership with her.  This superior position gives her the right to exclude those who think differently to herself, from her world.

–   The statement that anyone can set themselves up as a counsellor is at best a half-truth. The Department of Health, 2005, initial mapping project report (see [i]) states they found more than 570 training organisations in the UK. All these organisations will have their own training processes and way of monitoring their various practices. So anyone can call themselves a counsellor but they cannot claim accreditation to one of the existing training organisations. Any claimed memberships are easily verified on the internet.

-There is no evidence for Ms Osbourne’s claim that regulation of the entire ‘profession’ (I do not claim professional status) would eliminate the practice of conversion therapy. Supposing it is renamed ‘Regaining a healthy sexuality’, would it then be eliminated?

– Mr Lamb’s response could not be clearer. No to Conversion Therapy on the NHS (Any unwanted Homosexuality is not a matter for NHS treatment) No to regulation. Mr Lamb’s argument is a cost argument – too much money for too little result.  So Mr Lamb does not argue to try and ‘protect the health and wellbeing’ (HPO2001 : Health Professions Order 2001 : available here) is not possible or entirely bonkers but rests his argument on finance.

– To me, Dr Davidson’s argument is flawed. He starts from a position of knowing THE Truth: individual freedoms are at risk. He then moves to a further general assertion: the regulation of therapists is a bad thing. His conclusion is a tour de force:

“We call on the government to ratify evidence-based scientific data, “  This form of measurement in science is fine for physical phenomena such as length, speed, etc, and for bean counting in cost benefit analyses, but misses the most important ingredient, the relationship of trust.

rather than to promote political ideology Difficult! Is the Government’s wish ‘to protect the health and wellbeing” (object of HPO2001) of all its subjects a political ideology? Is Lord Layard’s assertion that economic happiness involves having a paid job, a political ideology (see [ii]? Is the Government’s measurement of Standard Happiness a political ideology? I would state yes. Then I invite you to read

Jacques Lacan’s : Seminar VII : The Ethics of Psychoanalysis : information Seminar VII: The ethics of psychoanalysis: 1959-1960: Jacques Lacan or here

The Direction of the Treatment and the Principles of its Power:10th-13th July 1958 : Jacques Lacan or here.

A different version of ethics and the position of the practitioner emerges. I also argue that conversations which may be called therapy, are not isolated from politics. Whether practitioners promote a political ideology is an important question.

which exploits and uses people who understand themselves to be homosexual, for its own ends Questions of the use of power in a treatment are very important. The practitioner and their training organisation must find ways to mediate its misuse. Supervision is extremely important in this respect as is belonging to a working network of fellow practitioners. However I find this use of the emotionally charged ‘exploits’ as a certainty, to be unsubstantiated.

So of our three protagonists, none of them win for their use of argument. And look at Norman Lamb’s position. He is prepared to stand up for a principle: against statutory regulation. Almost makes you look forward to the January debate!

POSTSCRIPT 

There is an interesting analysis, by Frank Furedi,  [Why south London’s ‘slave’ house is nothing of the sort : The slavery hysteria whipped up by the media and politicians is a convenient distraction from dealing with real problems of exploitation and low pay by Frank Furedi :  theguardian.com, Tuesday 26 November 2013 15.38 GMT : available here ] of the difference between the manipulative use of power and control, alas a shared human trait, and actions which are defined as against the law: Quote:

But trading on myths is a sad substitute for mature public deliberation. What we ought to be discussing is how to distinguish between controlling behaviour and acts that violate people’s ability to give or withdraw consent.

Conclusion

It is sad that I consider it too much to hope that Ms Osbourne and Dr Davidson could even approach an understanding of what is involved.

Footnotes


[i] INTERIM REPORT to DEPARTMENT OF HEALTH on INITIAL MAPPING PROJECT for PSYCHOTHERAPY & COUNSELLING – Joint BACP & UKCP : 2005 : available here

[ii] From Wikipedia : ‘In 2005 he published the book Happiness: Lessons from a New Science, in which he emphasised the importance of non-income variables on aggregate happiness. In particular he stressed the role of mental health and argued that psychological treatments ought to be much more widely available.’ : Available here.

Some other posts in LacanianWorks which comment on Lord Layard’s opinions:

‘policy-based evidence, not evidence-based policy’ : John Kay speaks : October 16, 2012 : or here

…his lack of any self-limiting principle. If the problem is limits, then this is a problem without an easy solution, because we too have learnt to be limitlessly acquisitive: Christopher Caldwell : April 27, 2012 : or here

Research which aims to understand and prevent adverse effects of psychological therapies – yes, really : March 8, 2012 : or here

The Government’s reforms to the NHS? A car crash in slow motion playing out before our very eyes. Stephen Wright : January 6, 2012 : or here

How Government Action goes wrong…. ‘The report says the department pushed ahead without undertaking basic project approval checks, taking decisions before testing the ideas for feasibility.’ : September 20, 2011 : or here

Registration and Regulation – an attempt at an update and the Government’s Happiness/Wellbeing Factories reappear : May 19, 2011 : or here

Psychotherapy is imposed: Psycho-analysis© works: Psychoanalysis operates : December 15, 2010 : or here

Reply to CON-sultation: Equity and excellence: Liberating the NHS White Paper July 2010 : October 9, 2010 : or here

Challenges to Government’s principles used to define the care of mental ill-health :July 15, 2010 : or here

Opposing the Section 60 Order which will make psychology a function of the state – as it was in Soviet Russia.  : April 16, 2009 : or here

Wellbeing & Happiness as used by the UK Government : May 7, 2007 : or here

 

Julia Evans

Practicing Lacanian Psychoanalyst, Earl’s Court, London

 

Related texts

Opposing the Counsellors and Psychotherapists (Regulation) and Conversion Therapy Bill or here

Use of power here

Ethics here

Responses to the UK Government action here

Government action here

UK Government here

Lacanian Transmission : here

By Sigmund Freud here

Notes on texts by Sigmund Freud : here

By Jacques Lacan here

Notes on texts by Jacques Lacan here

Of the clinic here

Some Lacanian History : here

Topology : here

Lacanian Transmission : here