Update: October 2003

Why is Frank Furedi so furious with counselling?

Professor Frank Furedi of the University of Kent has published a new book highly critical of what he calls the “therapy culture”.1 His publicity and promotional campaign has been so extensive - taking in journals as diverse as the Times Higher Education Supplement and The Sun - that the British Association for Counselling and Psychotherapy (BACP) would like to place his arguments in context.

  1. Many people in our society are suffering from real mental distress and counselling is a proven remedy.2
  2. Furedi criticises contemporary culture for adopting the language of psychobabble and victimhood. This may exist in the soaps and tabloids but it is not representative of any mainstream counselling thought.
  3. Most counsellors would share his concern about the glib labelling of behaviour as “addictions” where these have no obvious physiological component.
  4. His real target, therefore, isn’t therapy but “self-help” or “Oprah Winfrey” culture.
  5. For instance, most counsellors would agree with Furedi that it is undesirable to expect people to weep in public when they wish to experience grief privately.
  6. Counselling may have produced a (very) small number of less than effective treatments e.g. compulsory debriefing for trauma, but so has every active branch of healing. It is not reasonable to expect counselling to be infallible nor to dismiss the whole on the basis of the exception.
  7. Furedi complains that counsellors encourage “over-pathologising”, “client helplessness and loss of autonomy”. On the contrary, counsellors are not only aware of the need to avoid these tendencies they consider them to be bad practice.
  8. As the leading supervisory body, BACP is striving to make counselling better regulated and closing the field against poor practitioners and has done a huge amount in setting up a voluntary framework of regulation - but there is a limit to what can be achieved voluntarily, and financed by counsellors alone. The Government has so far failed to regulate the field itself.
  9. The mainstream counselling writers whom Furedi fails to research are full of considerations of these issues and accounts of how to field against poor practitioners and has done a huge amount in setting up a voluntary deal with them.3
  10. So is the Ethical Framework of the British Association for Counselling and Psychotherapy (BACP).4
  11. 11. Furedi represents an extreme range of worry about the ‘spread’ of counselling and psychotherapy but this quickly appears to merge into unreasonable nostalgia for the 1950s. According to one academic critic, his core appeal is to the forces of conservatism in both the Mail and Telegraph readership and places him: “in the same camp as those who bemoan the decline of the family, traditional values, male dominance and standards of spoken English”.5
  12. Accompanying Furedi’s spate of articles is the claim that “Britain has more counsellors than soldiers”. This line is false. There are 116,820 professional soldiers in the British army. There are only some 30,000 professional therapists in the UK, outnumbered four to one. Of course, the second figure can be inflated by including all those “possessing counselling skills” who claim to do it as part of their job. The newspapers quote a figure of 250,000 counsellors in total. Where does this come from? No source is given. It’s rather like calculating the size of the army by guessing how many people ever wear martial uniform and adding in the territorials, the combined cadet force, the boys brigade, all the girl guides and probably the boy scouts too. Britain’s “vast army of therapists” turns out to be a Furedi (Freudian?) myth.
  13. Speaking of headlines, the Daily Mail ran their extract from Furedi under the quaint 14th Century malediction: “A Curse on Counselling!” This anathematising appears to suggest something of a move away from reason in the direction of superstition.
  14. Counsellors and psychotherapists do not dislike the “stiff upper lip”. They recognise a place for stoicism and “soldiering on”. If you don’t agree, try therapy for yourself – it’s tough work, calling everyone to adult account. But clearly a society that relies solely on the stiff upper lip would have as many limitations as one that is emotionally incontinent.
  15. It goes without saying that Furedi’s book is polemical. He makes sweeping generalisations that are insensitive about tragedies like Aberfan without realising that some of those who were bereaved did not “move on” under their own steam while others have voiced outright condemnation of the system’s failure to offer “professional support”. The same is true of those affected by the last world war.
  16. Furedi book is guilty of false correlations. It does not follow that because certain cultural and social phenomena have happened over the same period of time that they have caused each other, eg:

    l Celebrities baring all (Lady Di; Billy Connolly)
    l The pathologising of everyday experience
    l The rise of “psychobabble”
    l The widespread availability of counselling.

  17. Furedi still has to prove which of these four (if any) causes which.
  18. As a sociologist, Furedi should recognise a “moral panic” when he starts one: “The country is going to the dogs. Help we are all going to perish or disintegrate. We must find safe and certain ground again. This therapy business is the single cause of our problems. Get rid of it and everything will be all right again”. If every last counsellor in the land were to be hanged by the entrails of every last psychotherapist, Britain would still remain a post-Imperial power in search of a purpose. And the changes in religious belief, family structure and social mobility would still mean that many people were seeking ways of making sense of their situations.
  19. Furedi says British society “has become increasingly influenced by the values of the therapeutic culture encouraging us to believe that we do not have the emotional resources to handle problems without professional guidance”. Does more help make people ill? Do anaesthetics promote more heart bypasses? Without schools, would we all teach ourselves to read?
  20. Furedi says: “In any given month in Britain, there are a mind-boggling 1,231,000 counselling sessions being carried out. Few organisations can now escape this trend” - but if there is one value at the heart of the counselling culture it is that counselling is and has to be entered into voluntarily. None of these organisations is forced by the counsellors to make counselling available.
  21. The origins of this figure is also fascinating (sourced from a private letter) and a puzzle in its own right. When you look at the breakdown, the largest component turns out to be 632,000 “counselling sessions”. How a statistic can contain an identical subset of itself is not known.
  22. Nearly half the figure cover “advice” sessions. Counsellors by definition do not give advice.
  23. The idea that the nation is awash with therapy and counselling is equally unsubstantiated. As Professor Andrew Samuels of the University of Essex has said: “There is a crippling shortage in the public sector of properly qualified psychotherapists and counsellors to attend to the emotional distress even of those whom Furedi concedes may need help”.5
  24. The evidence points to the opposite case. Counselling has spread because organisations have found it to be an extremely successful and cost effective solution.6 For instance, we know that workplace counselling can reduce rates of sickness/absence by as much as 50 per cent.7
  25. Furedi claims: “Experiences that were once just a normal part of life…are now portrayed as seriously damaging to a person’s well-being”. Evidence to support his headline-catching opinion that counsellors are responsible for this is scant. It was psychiatrists (not therapists) who invented “sexual addiction”, and psychiatrists (not therapists) who defined “attention deficit” disorders. Back in the 1960s, disruptive boys were called “maladjusted” and simply packed off to a special Boarding School. Labels are one-dimensional explanations that stigmatise the person who is labelled. Again, this is absolutely antithetical to the counselling culture.
  26. Furedi dislikes “Psychobabble”. If the professor wants to throw up barricades against simplistic, misleading misuse of pseudo-psychological terms there are innumerable counsellors who will assist him! He also falls into the same trap himself. He mixes up “babble” with real, disabling conditions such as the post-traumatic suffering of some people who have faced extreme danger. Perhaps he thinks the army was correct in 1914 for thinking execution was the cure for shellshock?
  27. “Rather than making people happier, as its exponents promise, (counselling) actually makes people more depressed.” Counselling has never promised to make people happy. Evidence summarised by the DoH shows that counselling is effective in treating a range of mental health problems. Counselling offers space for reflection, insight and the better containment of feelings (rather than incontinence). Furedi’s case is black and white and can’t see any of the ambiguities.
  28. “Surely it is best to rely on traditional British courage?” he argues. So, it’s away with all this namby-pamby stuff like modern high-speed drills at the dentist and epidural blocks for complicated childbirth! Let’s get back to basics by biting on sticks while your leg is amputated… It is also insulting to suggest that people who seek counselling lack courage. Often (just like survivors of trauma, assault or bereavement) they have displayed exemplary courage but seek help to deal with subsequent anxiety or depression.
  29. Furedi has let himself be -used by the media who care nothing for academic nicety. If you deconstruct the Mail’s almost weekly propaganda against the new "emotionalism", you will find a conjuror's prestidigitation but no persuasive evidence. For instance, to justify a recent headline: "Counselling can worsen pain of disasters", their "science" correspondent relied on data showing inconsistent findings with only a minority indicating negative outcomes. The truthful headline would have read: "Counselling can lessen the pain of disasters". It was also interesting that the Mail derided the tears both of Greg Rusedski when he lost Wimbledon and Roger Federer when he won it. The forces of the 1950s require the lachrymose to keep it to themselves. Dr Furedi is in a strange bed (interestingly, Furedi in the book is critical of the -Mail (p112) as a paper which promotes the myth of psychological illness in its headlines, but he somehow omits this criticism when writing for them).
  30. Paradoxically we are in the middle of a therapy boom. Even Hilary Rodham Clinton can exclaim: “Counselling saved my marriage”. Fear of change is perhaps the true problem causing society to be in two minds about the arrival of this new profession. One obvious conclusion is that therapy has come of age to be an established part of the British way of life. When major sociological commentators and their friends in the media are reduced to impotent cursing, we must have passed from alternative therapy into mainstream provision. The paradox, as mentioned, is that Furedi and good therapy are both on the same side in opposing over-simplistic psychological notions and ill-researched interventions.

Tragedy of the 999 man called to one suicide too many

A paramedic killed himself two days after battling to save the life of a father who had been found hanged. Wayne Davenport was left extremely traumatised after fighting in vain for 40 minutes to revive the man, an inquest heard yesterday. Within 48 hours, his fiancée found him hanging at his home.

Mr Davenport, 34, had earlier injected himself with a strong anaesthetic. His work partner, Matthew Wise, told Rochdale Coroner’s Court that Mr Davenport had been called to at least five fatalities – including two suicides – in the six weeks before his death. The last one occurred during a long and difficult night shift.

‘It was extremely emotional’, he said. ‘We were offered counselling by our control team but we talked and said we didn’t need it…’ The Daily Mail, 17/10/2003

References

1. Frank Furedi is professor of sociology at the University of Kent. His book Therapy Culture: Cultivating Vulnerability in an Anxious Age is published by Routledge, £14.99.

2. A study summarised in the BMJ on 2 December 2000 shows that the most effective help for most depressions (ie those lasting less than a year) is counselling. According to the Department of Health, cognitive therapy is the treatment of choice for eating disorders, phobias as well as for many depressions and obsessive-compulsive disorders – see “Effectiveness Matters" - www.doh.gov.uk/mentalhealth/treatmentguideline/index.htm

3. Such as Egan, Thorne, Dryden, Jacobs.

4. www.bacp.co.uk/ethical_framework

5. Professor Andrew Samuels of Essex University in a letter to the Sunday Times: “Frank Furedi yearns for a pre-therapy time that he must know never really existed – a time when people stood on their own two feet and dealt with things fairly and squarely without recourse to and dependence on the assistance of others. The problems are not new and hence not constructed by the therapists. He is in the same camp as those who bemoan the decline of the family, traditional (religious) values, male dominance and standards of spoken English” – October 2003

6. ‘Counselling in the Workplace - The Facts’ by Professor John McLeod of the University of Abertay, Dundee, examines over 80 separate studies, published and unpublished, spanning a period between 1954 and 2000 reflecting the experiences of more than 10,000 clients who have made use of workplace counselling. The 108 page report can be obtained from BACP priced £18, p&p free.

7. For every $1 spent through Employee Assistance Programmes (EAPs) on workplace counselling - between $6-10 was being saved for our Company with the workforce receiving the direct benefit. I believe that we are a far more efficient organisation with counselling in place through the use of EAP" - Dr Mike Doig, Medical Director Chevron (Europe); Member of the UK Offshore Health Advisory Committee.

The British Association for Counselling and Psychotherapy is the leading voice in its field and happy to comment on this and any other issue to do with talking treatments in the UK and worldwide. Please contact Phillip Hodson 020 7794 2838, phillip@philliphodson.co.uk Head of Media Relations, BACP, or Lewis Edwards 0870 443 5243, lewis.edwards@bacp.co.uk Communications Manager, BACP.
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