Systemic Means to Subversive Ends: Maintaining the Therapeutic Space as a Unique Encounter

Abstract

Psychotherapy has become a marketplace for an increasing number of approaches – over 400 at last count – with wildly different perspectives on what it means to suffer, and whether an approach focused on cure is possible and advisable (Cooper and McLeod 2010). Within this marketplace, CBT has become the dominant approach, as has an ideology that revolves around notions of ‘illness’, ‘cure’, ‘regulation’ and ‘evidence base’. This is challenging for the critical practitioner; maintaining space for alternative, subversive approaches is problematic when most believe therapeutic techniques can be decided prior to the unique encounter between a psychotherapist and patient (for example Loewenthal 2011). This chapter has a simple aim: to argue that rather than be slave to such changes we can, and must, develop and train new generations to maintain spaces in the public arena for multiple approaches to storying distress and treatment. To this end I will demonstrate how systemic techniques, influenced by post-Foucauldian theory, were incorporated into a doctoral training programme that was subject to increasing pressure to become mainstream. Such ‘critical competencies’ allowed trainees to situate themselves in an alternative story of the future of psychotherapy – one where we ally closely with the psychiatric survivor movement, and use ourselves as sites to question norms whenever we come across them, be that on social media or in a team meeting. I aim to show that techniques for playful subversion of mainstream ideas outside the consulting room can maintain room for a practice-driven psychotherapy, and empower trainees to feel that they can influence what happens next.