Thursday, 28 February 2013

Researching talking therapies and homeopathy

Researching talking therapies and homeopathy

Research involving people is challenging and even more so when it is not just focussed on their physical bodies. The NHS and NICE pretend to like ‘evidence based practice’ but it not as simple as that. And even if it was we don’t have the time or money to do Randomised Controlled Trails about all that we would like to. And when money is available for trials the money source often controls whether the results are published or even made available to other researchers. For example drug companies still repress findings they don’t like; the Home Office ignores research it has funded in prisons when it does not get the results it wants. And don’t get me started on Gove and education!

Back to topic. What works for whom sounds like a good idea – choose a problem and test out possible treatments. What we find with psychological research is that what happens in the lab is not always what happens in the clinic. For example to test out a psychotherapy or CBT on a problem then participants are carefully selected to only have that problem. This is atypical. Many people present with multiple problems. You might select 20 out of several hundred possibles for your actual study. And practitioners behave differently in research than outside. For example they are more likely to follow the manual in the research lab. But it is worse than that there is a lot of variation between individual practitioners using the same approach more so than between the averages of competing approaches. And we know that it the quality of the therapeutic alliance that is the biggest factor in successful outcome not the school of psychotherapy/CBT used. Arguably all work with whom up to a ppoint.

So probably (as Arbuckle suggested back in 1967) it would be better to research the individual practitioner rather than their modality and for me that means Who works with what? In other words focus on the practitioners getting the best outcomes with particular client problems and study them. (This has been done it is apparently how NLP got started) And it is how I do and maybe good practice managers do referral.

Onto homeopathy which does not appeal to me and doesn’t seem to work for me but it does sometimes very strikingly for my wife and did so for my daughter when she was a young toddler. The problem is that homeopathy will offer differing pills for the same client problem on the basis of their curious approach to diagnoses. So the pills offered will vary according to the individual client. (The same would be true for some kinds of psychotherapy in terms of how they work also). It is really a question of whether the treatment is intended to remove the symptom or regard the symptom as part of a bigger picture that might well need addressing. Thinking giving up smoking or drinking. Who knows what problems this might be masking, how this behaviour fits a particular individual’s patterns.

Interesting homeopathy and talking therapy give people plenty of time to share their problems, both listening very carefully. Your GP does not have the time and yet millions of us are presenting them with psychological/mental health issues. In this crazy modern world we all need a good listening to, sense of belonging of family and community, until that happens the mental health epidemic will continue.

But there is a horses for courses issue here. If I have a chronic infection I want antibiotics, a broken leg I want it setting, cancer I probably want surgery. But when it is not (just) physical, say when my life feels grey or I have fallen out badly with those I love, I need to talk, I need help not drugs or pills.

Tuesday, 19 February 2013

New mystic

Paul met Maurice at Croma, just off Albert Square in the centre of Manchester. Croma was a convenient for the courts, the banks and other money men – still mostly men – who worked for a (dis)honest hundred grand or two nearby. Croma was nothing special to look at but it did serve decent Italianish food, at a fair price, with an efficient, friendly but non intrusive staff. Paul had a soft spot for Croma as it was one of his daughter’s favourites. They both always eat the same food there - Americano pizza for Paul, Lasagne for Catherine, which also included shared garlic bread and a rocker leaf salad with balsamic vinegar and parmesan cheese and tiramisu to follow.

But today Paul was meeting Maurice – Rachel’s lawyer – in order to share their understandings on developments in her case. Maurice was seating in a quiet alcove waiting for Paul when he arrived on time. He didn’t look quite like a lawyer – whatever that was. He was wearing the right kind of non descript grey suit – not too expensive but certainly not cheap. He also wore a suitable tie, not quite recognisably old public school but it could be. The thing is Maurice had a rakish moustache and a grin go with it that kind of undermined his thoughtful lawyer look. He was just too alive, too dangerous if you like.

They shook hands, ordered pre lunch drinks – corona for Maurice, cappuccino for Paul.
- So why are they keeping Rachel in prison?
- It partially protective, for her own good.
- Whaaaat?
- Well since her canal boat was blown up…
- They think her life is at risk?
Maurice nodded and they paused as the waiter came to take their lunch order. Paul continued,
- But don’t they know how prison is affecting her…She’s lost weight….become withdrawn, maybe even depressed. She is at risk staying inside.
- I know but they don’t care. I need some new line to make a case for her release on bail.
- Hmm… What about her being granted bail on very restrictive conditions, where she lives, reporting regularly to a police station, even tagged?
- I’ve tried all of that.
- How about a report form a shrink or a clinical psychologist?
- On it’s way, it might just swing things.
- I can’t believe they feel she is a public risk. She is a gentle soul in my view.
- I agree, but it’s not me you need to convince.
Paul nodded and grew silent as their waiter delivered their food and offered the obligatory over sized pepper pot.
- How do you want my investigation to proceed?
- Follow up any leads with Dave Ashton. I am sure he is involved somehow but the police don’t seem at all interested in him.
- Will do.
- The police are getting nowhere in figuring out who blew up Rachel’s canal boat. You could speak to her again about it.
- Sure, I was intending to see her again soon in any case.
- I’ve got to be back in court soon.
- OK stay in touch.
Maurice nodded, shook hands with Paul and left.

Paul nursed the remains of a cup of cappuccino and let his mind go blank and his breathing slow down and deepen. In his mind’s eye he saw Rachel’s boat, bobbing on the canal. It was dark. Then he noticed a shadowy figure fixing something – was it semtex – to the stern of the boat. Paul took another slow deep breath, hoping to see more, but the image faded. Was it Ashton he saw or someone else? Paul couldn’t be sure.

Thursday, 7 February 2013


As some of you will already now I have recently been appointed Visiting Professor in Counselling and Spirituality at the University of Central Lancs with my inaugural lecture set for March 7th. I am obviously made up about this and there are a few things opening up around me that I am getting excited about and a little bit scared about (more of that later) that suggests something bigger is going on.

I feel that I have earned this appointment and it was so nice to be asked out of the blue. I don’t feet that I deserve it but that’s me and my stuff. However, I wont let such feelings get in the way of the work that now becomes possible. Being a professor opens doors and I want to make the most of it in terms of promoting the kind of research and teaching that has always appealed to me.

Back to the scariness: I seem to have to scare myself at regular intervals rather than plough the same old furrow. And the something bigger, well a few times in my life with COPE, Manchester Reich Group, Energy Stream, PsychoSpiritual Initiative, my PhD group at Manchester, I have found myself part of groups of people that have come together to do something really interesting. It feels like it might well be about to happen again!