Dr Isabel Henton, Chartered and HCPC registered Counselling Psychologist, is Head of Programme of DPsych Counselling Psychology. Here, she explores how philosophy could offer us comfort in these trying times.
This article is part of our new series, Regent's Review: thoughts, research and academic discussion on the rapidly unfolding pandemic.
Some consolations from philosophy
- Anxiety is not only inevitable, but potentially the only vantage point from which to explore how to live. The concept of crisis is an important idea in counselling psychology
- Therapy, with its careful investigation, can help us understand how events, themes and relationships colour our lenses and help us understand crises.
Some philosophical consolations
In the wonderful title of his book, How to stop living and start worrying (yes, you read that right), flying in the face of all self-help and positive psychology tomes that have come before or since, philosopher Simon Critchley reminds us that anxiety (along with one of its cognitive signs, worrying) is not only inevitable, but potentially the only vantage point from which to explore how to live. It is not so much perhaps, how to start worrying, but how to get really good at it. Philosophy, Critchley suggests, is an attempt to worry well.
What does this mean and how can philosophy help? One starting point could be to think about what a crisis means. The word comes from the Ancient Greek krinein (to decide). A crisis is a decision point, a pivot, trigger or turning point, a critical incident that brings things to a head – the straw that broke the camel's back... after which things may get better or worse.
The concept of crisis is already an important idea in my own discipline of counselling psychology, which could be considered a descendent of philosophy (as well as of other domains such as humanism, postmodernism and psychoanalysis). In attempting to understand a client's predicament, we sift together through the various incidents and accidents of their lives, assessing the ‘situation.’ This includes attempting to find the pivot point – the question boils down to ‘why now?’ In other words, what has led to their arrival in the consulting room on this day and not on another?
Visiting our NHS Grenfell Health & Wellbeing Service placement in early 2019 gave the DPsych Placement Coordinator and I an example of the link between a crisis and a cause. The tragic event of Grenfell had led to the establishment of an outstanding new service: a large multidisciplinary team of practitioners involved in individual psychotherapy, physical therapies, group work, outreach, recovery services, gardening projects and more.
Standing in the garden and looking at the tower in the distance, we spoke to one of the counselling psychologists from the team we met that day. She told us that through her work in the service she had witnessed how, while the experience was in one sense shared by all those affected, it was interpreted very differently by each. Everyone had their own lens through which to understand what had happened. Careful investigation in therapy led back in time towards significant events, themes, relationships with others, contexts or learnings that coloured each person’s lens. Precise interpretative links could be made, in other words, between the meanings made of the crisis of Grenfell and deeper roots or causes from the past.
As my colleague Professor Martin Milton recently suggested in this Regent’s Review, in the midst of the current crisis, it may not be helpful or possible to do this kind of interpretative work, either for ourselves or with others. Given this, my colleagues on the DPsych have been exploring how best to guide and support our trainee counselling psychologists in adjusting their mode of working. In this, we have faced significant challenges. Trainees must try to navigate, and we alongside them, not only the shifting clinical situation, but the evolving policy mandates from the institutions governing the programme. Alongside Regent’s, these include the British Psychological Society, the Health and Care Professions Council, The Open University and the Quality Assurance Agency.
Being subject to the understandable COVID-19-related organisational anxieties of one institution is one thing; surfacing to a new reality involving five institutions (along with 50 or so placement organisations) all doing their absolute best to adapt to major change, has been something else. I am sure we are not alone in this. The changes to our programme have affected almost every aspect of our four handbooks – our learning, teaching and assessment; every professional practice process; every placement, client and supervisor; every doctoral research project; every personal therapy, and it continues.
Never has our programme’s commitment to pluralism – that is, a philosophy of knowing thoroughly devoted to uncertainty and difference (as well as to conflict between different ways of knowing) – been more pertinent, as potentially conflicting institutional ideas have begun to emerge over the redeployment of NHS mental health services, the conscription of counselling psychologists in training, the placement hours model, how to guarantee attainment in a professional training, and more. In this fragmented situation, there is what Derrida might call undecidability – but, as he also suggested, we can, and we must, still, decide. Pluralism is not anything goes; our decisions in this crisis have felt worth worrying about.
Reviewing this article, I realise (as you may have done too) I haven't quite yet answered the question posed. What does it mean that anxiety is the only vantage point from which to explore how to live, and that we should start getting good at worrying?! Suddenly, the data or givens of our experience have shifted – and this is shared, in this we are connected. Nevertheless, it may remain helpful, as and when we can, to engage in the idea that data don't directly lead to conclusions. In between our data and our conclusions, we are all interpreting differently.
In cognitive behavioural therapy, one of the three forms of psychotherapy we teach on the DPsych, this is as simple as ABC – A (events) are mediated by B (interpretations) leading to C (outcomes, conclusions). If we take seriously the difference between us (and our interpretations), and our inherent separateness from others, it is anxiety-provoking – but it also means there are more possibilities. This is definitely not a pathway towards certainty, only a starting point for philosophising perhaps. All I can do is wish you (worryingly) well.