This pace of moral decision-making poses insuperable challenges to several ways of thinking about right and wrong…. Giles Fraser

by Julia Evans on January 20, 2012

Quotes from: ‘A regiment forms a moral soldier’ by Giles Fraser, Church Times. 20th January 2012 and available here.

 

My reason for interest in this article is the difference between formation and the Government’s, through its agencies: HPC , CHRE , Skills for Health , NICE , enforcement, using Privy Council  power, of standards for training, continuous professional development, entry criteria, fitness-to-practice standards, ethics and their measurement.

 

So the Government takes what Giles Fraser describes as ‘a de-ontological approach that tries to capture what is right within a set of rules (such as the Ten Commandments)’.  I must remember ‘de-ontological approach’ for my next submission into Parliament. It sure beats accusing them of wanting megalomaniac control of everything, including a trust relationship between two human BEINGS. Giles Fraser concludes, and I agree with reference to regulation of talking therapists, that ‘the whole thicket of law feels overwhelming.’

 

So how do you make moral decisions on the battlefield, oops – I mean, in the clinic? Quote op. cit.: ‘The challenge is not only that these decisions are obviously a matter of life and death, but also that they have to be made quickly, and in a fast-moving and inherently confusing environment. For the most part, in civilian life, we are given a certain leisure to reflect on the decisions that we have to make. We can chew things over, and take our time to get things right. This is a luxury that soldiers (JE: or Therapists/Talking Practitioners) often cannot afford.’

 

‘This pace of moral decision-making poses insuperable challenges to several ways of thinking about right or wrong.’

 

‘Can a soldier really know all this stuff, and recall it in the very instant when bullets are flying around? Can he or she be thinking about whether a particular rule applies to this particular situation, when no one has had much sleep for 24 hours, and the fog of battle feels like complete chaos?’ Can a Talking Therapist really recall the Government’s standards, as stored in their central library of standards (see the July 2010 White Paper: Equity and excellence: Liberating the NHS [i]) when faced with a fellow human being in various states of distress?

 

Further extensive quote: ‘My own sense is that this is where moral formation takes over. In these circumstances, you make decisions out of instinct, not out of an encyclopaedic knowledge of the rules. So the vital question is how your moral instincts are shaped. I suspect that, in reality, when instant decisions are called for, the soldier comes pre-loaded with an instinctive moral response.

 

This instinct is shaped by several factors, but most importantly by a sense of identity that has been shaped by his or her moral community, the regiment. It is this community, with its traditions and practices — its pride and self-understanding captured by stories of former glory and oil paintings in the mess — that is the moral context for decision-making.

 

We act morally out of a sense of who we are. When these historic regiments are messed about with or scrapped, this context is disrupted. This is why the reorganisation of historic regiments can be a dangerous business. Morality is much more than the law.’  (end quote)

 

To repeat: The vital question is how your moral instincts are shaped. We act morally out of a sense of who we are. What is the moral context for decision-making?

 

Practices of formation, developed from over the last 100 years to forever, are based within communities of practice (‘moral contexts for decision-making’), usually known as training organisations.  Now, as outlined by Giles Fraser above, these communities of practice are about to be destroyed.  This means the individual formation of the practitioners, maybe through years of subjective engagement within the practice, is deemed unnecessary. As is the formation of the practitioner through supervision, and engagement within their practitioner community to develop their unique practice, examining their practice in their cultural context, and allowing their practice to be examined by others in their network: case study work, presentations, etc.  Some of the results of this are given in LacanianWorks postings. See [ii] for details.  I especially recommend Kevin Jones’ post.

 

So the Government’s de-ontological approach (I love it!), leads to ‘Wellbeing Practitioners’ being trained as if they were about to operate a till in a Tesco supermarket.

 

So why do the ‘Famous Five’ (see  [iii] ): comply with the Government?  Good question. It is to secure jobs for their members. In Therapy Today, February 2012 issue, is an article where ‘counsellors’ become Government agents in chasing the population back into work.  Their bonuses depend on it as do the Government’s Contracted-Out-Agency’s profits.

 

There is evidence that regulatory capture is in place.  So the Famous Five (endnote ii) ‘advise’ the CHRE on how to regulate so that they fit within the rules – in secret meetings, of course.

 

There is also evidence the Famous Five have been sold a dud.  In an advertisement spotted recently, (I will try and get a web-link), an advert for a psychologist states that HPC registration is essential but membership of the BPS is not.  So Practitioners working within the Government-protected high-risk mental health industry, are outside communities where practices are held and developed.  Think ‘Animal Farm’.  Now the HPC, CHRE, Skills for Health, NICE, evidence-based-evaluation, are in place, there is no place for the Famous Five to exist. They are window dressing as they have no function.  In complying with the Government, they have done themselves out of a job.

 

To conclude: It matters in which context the following quotes are put:

‘The vital question is how your moral instincts are shaped. We act morally out of a sense of who we are.’

 

Is it within the Government’s high-risk & largely contracted-out mental health industry or is it within a relationship of love and trust between two equal human beings which is held in a human network or moral context of shared practice.

Note: My engagement with Giles Fraser’s views on this topic began in September 2010 at a talk he gave within St Paul’s Cathedral, where he then worked. This I applied to Government action within the area of Mental Health and circulated to the regx2 group as ‘Ethics and the HPC…..  (& Government):  Comments from conversations’ on the 20th September 2010. Subsequently I expanded the arguments and included them in my response to the ‘CON-sultation: Equity and excellence: Liberating the NHS White Paper July 2010′. This is now available on LacanianWorks – see endnote [i]

The comments are in the section, ‘b) How do you train an act which relies on individual judgment in conditions of stress?’  The following are its opening sentences.

‘In the Lacanian orientation there are four components: the individual’s analysis, supervision, development of practice through case presentations and developing new frameworks in response to developments in the clinic. Although the individual analysis may finish, the other three components always remain in place.’



[i] My response is posted to LW as follows: Reply to CON-sultation: Equity and excellence: Liberating the NHS White Paper July 2010 by Julia Evans on October 9, 2010

[ii] Lacanian Works

Posts for the “Changes to Practitioner training” category

Sadeian power, the UK Government……… & CON-sultations by Julia Evans on February 3, 2012

Jacques Lacan’s texts on the principles of power as applied to a treatment and tackling power and control within psychoanalytic organisations by Julia Evans on November 24, 2011

Same old, same old at the HPC: HPC council meeting Thursday 31st March 2011 by Bruce Scott on March 31, 2011

Fit to Practice? The Experience of State Registration from the perspective of an art therapist by Kevin Jones on October 9, 2009

Art therapy as a profession has never critically reflected upon the effects of state regulation on its teaching and practice. There is  no evidence that state regulation has improved either (…)

It almost looks as if analysis were the third of those ‘impossible’ professions in which one can be sure beforehand of achieving unsatisfying results. The other two, which have been known much longer, are education and government. by Julia Evans on January 2, 1937:  Quote from Sigmund Freud, who wrote this 75 years ago

 

Lacanian Works

Posts for the “Changes to the function of Training Organisations” category

Sadeian power, the UK Government……… & CON-sultations by Julia Evans on February 3, 2012

Laing was rattling the cage of an establishment with vested interests who did not like to be questioned or held to account. by Julia Evans on September 6, 2011

Same old, same old at the HPC: HPC council meeting Thursday 31st March 2011 by Bruce Scott on March 31, 2011

Fit to Practice? The Experience of State Registration from the perspective of an art therapist by Kevin Jones on October 9, 2009

An explanation of Jacques Lacan’s use of cartels in organisational structure by Julia Evans on November 1, 1997

 

[iii] Famous Five (after Enid Blyton’s heroes) refers to those collaborators who are helping to define the Health Professions Council’s (HPC’s) competences, negotiating service within the Government’s Happiness Factories (IAPT), Negotiating in secret with the CHRE so it regulates to their wishes, and so on.  They act to protect their interests: supporting the enshrinement of practice in standards which are driven down using top-down control.  They are:

UKCP United Kingdom Council of Psychotherapy,

BACP British Association for Counselling and Psychotherapy,

BPC British Psychoanalytic Council,

CPCAB Counselling & Psychotherapy Central Awarding Body is a UK awarding body that is managed by professional counsellors, trainers and supervisors. Now in their 16th year of operation, they are the only awarding body in Europe to specialise in the field of counselling. They are one of the largest awarding bodies in this field, with about 130 Recognised training centres across the UK (with some centres in other countries) and around 11,000 candidates registered with them annually.  All CPCAB qualifications have been updated and revised in 2010 to reflect the most recent research findings on the effectiveness of counselling and to anticipate the proposed requirements of statutory regulation.       and

BABCP   British Association for Behavioural & Cognitive Psychotherapies is the lead organisation for cbt, the Government’s treatment of choice, in the UK.

BPS is the British Psychological Society.   The BPS is a founder member of the Psychological Professions Alliance Group (PPAG) members not currently registered with the HPC are: British Psychoanalytic Council, United Kingdom Council for Psychotherapy, British Association for Counselling and Psychotherapy, British Association for Behavioural and Cognitive Psychotherapies. Members of the British Psychological Society are already regulated by the HPC. This group forms the dominant part of any CON-sultative group to S4H, IAPT, HPC, etc  They hold in common with the Government that it is possible to “safeguard health and wellbeing”  (See Health Professions Order 2001 – HPO2001)  An example of their key role in ensuring jobs for their members which also safeguards their future: