Here in the UK (which is where I am based – but what I am about to write has its equivalencies in other countries) it used to be that most newly qualified psychotherapists tried to find work in the National Health Service (NHS). People looking to have psychotherapy and counselling also went to the NHS and usually found free treatment of different kinds available over long periods of time. 

These days treatment is shorter, work tends to happen mainly outside the NHS, and counsellors and psychotherapists of all persuasions are encouraged to set themselves up as small businesses with no ‘medical’ connection.  Attitudes to treatment are changing. The medical care model that focused on improving an individual’s agency and autonomy is being replaced by a business model embracing ‘conservative’* values: people are responsible for what happens to them and therapy will make them more productive rather than problematise what they do.  

Psychotherapy, like most enterprises inflected by a ‘trickle-down’ attitude doesn’t do enough to help people navigate a world rife with predation. In particular I’m thinking of a certain tendency that seems aligned with conservative values: ones shared by people on the political left and right who haven’t moved beyond regarding misogyny and racism as pragmatically avoidable attitudes. I’m talking about the idea that a client, one usually met emerging from a terrible situation, needs first and foremost to explore ‘their part’ in what has happened.

There are very good reasons why it might be wise for someone to explore whether their actions arise from less conscious motives. That is, tendencies which they are blind to, which a psychotherapist might talk about in terms of phenomena like transference or dissociation, which might lead to an individual repeating mistakes. Discovering that you have more about you than you might realise, good and bad, is in many ways what psychotherapy might be all about.

However, the insistence that these need to be investigated as a priority, trying to understand how someone helped get themselves into a bad situation, is … I was going to write: misguided. It’s more than that. Much psychotherapy, especially Cognitive Behavioural Therapy, seems to have evolved towards finding ways we can feel in control of our lives and be more productive. Clients (patients, service users) are encouraged to effectively say ‘I could have known what I was doing all along’. They made a mistake and won’t do it again.

It’s far more frightening to look at the thought that very often our lives are taken over, impacted by people and things over which we have no control, and that if we are in some way regarded as gifted there will be a queue of individuals looking to exploit that gift in the service of their own life.

Let me introduce an imaginary client who might stand for many of the people I have worked with. Let’s say I met with them last week, and let’s call them X. 

When I asked X why they thought they needed to see me they were blunt: ‘I’ve been in three relationships in the last seven years. Every one of them started the same way, and ended the same way. Really badly, most recently in court. One of my friends told me I needed to work out why I keep getting into relationships like those.’

I asked them if they could talk me through one of these relationships as if they were a commentator, someone just following what happened as they might if they were describing an event on television. One where they had to be careful they didn’t disturb the proceedings; one where they had to keep their voice down a little.

‘I -’ they began.

‘What if you start with “they”?’

Looking at what happened from this perspective some things became clear. X wasn’t in the best of places physically, perhaps mentally, when the relationships they told me about started. They’d been tired from studying or from very demanding work projects – periods of intensity that left them looking to have some fun, and enjoying someone else’s company. These are things I’m used to hearing about: predatory relationships, ones sustained through coercion, beginning when someone like X is more vulnerable than usual, as we all are sometimes, but generally as a result of them doing their thing. Being excellent in some way, any way, I suppose; special enough to cause the kind of ripples that might attract a predator.  Narcissists, sociopaths, the desperately insecure: they are all on the lookout for someone to make life feel right for them.

‘Rather than wondering what part you had to play in this,’ I asked them, ‘what about the idea that these people were predators and that you didn’t manage to escape them?’

They laughed. ‘I’d hardly call them all predators.’

‘They come in all shapes and sizes, you know. If someone lines you up as the one that they need, there’s very little they won’t consider doing – or they might do without realising they’re doing it, because we’re talking about something primitive here. Something more instinctual than considered.’

Any one of us (or all of us together) can be seduced or deceived and betrayed. The thought that anyone can be deceived, especially when the deceiver may have no conscious idea that they are mounting a deception is always likely to be unnerving.  Psychotherapy has a range of ‘why I bought into this’ type interpretations or explanations, and it’s probably got something to do with countering this fear: a psychotherapist needing to be knowing, or clients wanting to feel things are under control.

The most profound drives that people experience – ones that for them are a matter of survival – are rarely ones they can consider on their own. Some things we’ll never see: like writing on our faces.

Predators. They’re all over the place and the best thing a psychotherapist can do for their client is to help them take a look at whether someone may have bought into them like a predatory takeover by the worst kind of private equity operation. And of course, while they are doing this, that psychotherapist might be opening someone’s eyes to why mental healthcare may have a latent predilection for encouraging forms of treatment in which clients first and foremost ‘own their part’ in what’s happened to them. Venture capitalists, private equity firms, these are really the people driving developments in clinical practice. It’s all about being productive without thinking for whom, and why?

There’s a necessary selfishness to life that is hard to understand. It isn’t about becoming an individual; it’s about finding a place among other people in a group, interdependence and improvisation.