What is psychotherapy and how does it work? Is it a profound method of self-discovery? Or a crude form of indoctrination practised by secular priests? Or is it thing very much but a delusion without any real scientific evidence to back it up? John Eaton, a practising psychotherapist in the UK since 1989, examines all these questions and more. John starts by looking at the science of therapy since Freud, taking in theoretical arguments for its effectiveness and at the results of outcome and process research. He concludes that the evidence is equivocal at best and does t show that specific approaches and methods are of proven worth although there is plentiful evidence that individual clients do benefit from working with gifted therapists. However, it is difficult to demonstrate exactly what skills good therapists do possess. The fact that therapy takes place in interview conditions by means of a conversation makes it impossible to follow using quantitative research methods. Is therapy then, t a science, but a type of discourse, an exercise of Power, as Foucault argued? Which relies on ways of thinking about the Self, the Mind, the Unconscious and Health through methods that date back to the French Revolution? A method that uses language practices to assist the distressed, the confused and alienated and to help them integrate back into the social order? John Eaton shows that psychotherapy, as practised in the West, is streaked through with historical assumptions that often go unexamined and which are reproduced by Freud and other psychologists. And that clients should be on their guard against seduction. However, therapy is t a single, fixed method and it cant be shown that it uses the same devices in every interview. Clients can, and do, resist interpretations that are t to their liking and they often treat what therapists have to say with irony, anger and contempt as John shows in transcripts of therapeutic sessions. Next John examines the claim that psychotherapy is a kind of indoctrination in which clients are seduced by means of metaphor and other devices into accepting the ideas of the therapist. Texts and interviews by Freud, Wilhelm Reich, Joseph Wolpe, Arld Lazarus, Carl Rogers, Fritz Perls and Albert Ellis are analysed and show that there is a powerful streak of rhetoric at work throughout. But, again, there is a stumbling block - clients. Therapists can only get away with as much seduction as their clients allow and, quite often, it is they who end up confused and powerless. The final chapters conclude by examining how therapeutic conversations actually work. Using devices such as turn-taking, stories, scripts, formulations, explanations, speech-acts, tag questions, and metaphors. What emerges is that clients create therapy-in-action just as much as therapists do, which is why it is so difficult to study using quantitative methods. It also explains why there is such a large gap between theory and practice in psychotherapy and why so many therapists rarely follow the techniques and methods they were trained to use.
Dr John Eaton is a UKCP registered psychotherapist practising in the UK since 1989. He holds a doctorate from the Department of Psychology at the University of Lancaster.