Book Review: Committed Uncertainty in Psychotherapy

Committed Uncertainty in Psychotherapy

Essays in Honour of Peter Lomas

Edited by Lucy King. 1999. London: Whurr. 162pp.

Although not described as such, this book is a Festschrift, in honour of Peter Lomas' 75th birthday. It consists of papers by twelve authors, including Michael Jacobs, David Smaill, Paul Roazen and our own John Heaton, on Lomas' contribution to psychotherapy. Trained originally as a G.P., Lomas became a psychoanalyst as a part of the Independent group, i.e. not aligned with either the Contemporary Freudians or the Kleinians, and worked for a time at the Tavistock Clinic. His own earliest papers on issues of family dynamics are from this period. He was apparently well regarded by his teachers among whom were Charles Rycroft, D.W. Winnicott, Michael Balint and Marion Milner, and also by his peers. While at the Tavistock he worked with R.D. Laing researching into family dynamics and according to Mullen (1995) he is one of the few people Laing had any respect for. Laing contributed a paper to Lomas' first book (1967) which is referred to in Clay's (1996) biography of Laing. Lomas eventually found both the claustrophobic atmosphere of British psychoanalysis and the narrowness of the analytic thinking of the time so unsympathetic that he left. As did Rycroft, Bion and Laing, all for similar reasons, although entirely independently of one another.

He first stated his objections to psychoanalysis in 1968 (ed. Rycroft 1968) and this still makes for relevant and exciting reading today. His thesis, echoing that of Laing (1965), is that since psychoanalysis is based upon research carried out under the paradigm of Natural Science it is an inadequate tool for conceptualising and making sense of the human condition, and what is needed is an Existential Analysis which values experience and views the person as a being, as the agent of his or her actions. He was not necessarily abandoning the notion of science as such because science is simply '...systematic and formulated knowledge'. (The Oxford English Dictionary) merely saying that psychoanalysis should not be submitted to the rigours of Natural Science because it is based on observations in order to determine causal relationships and qualities with the assumption of that both people i.e. therapist and client are essentially passive or reactive. And this is not a realistic description of being. Lomas (1968) makes a convincing case for psychoanalysis to regard itself as a Human Science based upon phenomenological investigation similar to that made by Giorgi (1970) with respect to that of psychology as a whole. Although few would disagree with this now, it was Lomas who grasped most fully the implications for understanding the human condition, therapeutic practice and also training. What gives his stance such authority is the depth of his knowledge of psychoanalytic theory and practice as well as of Existential philosophers like Heidegger, Sartre, Kierkegaard, Tillich and Buber. His first two books (1973 and 1981) are regrettably out of print but his more recent work can be accessed in The Limits of Interpretation (1987). In this book he explores his objection to psychoanalytic practice with respect to its reliance on theory and technique over relationship.

Regarding the therapist's role which he explored in Cultivating Intuition (1994) he felt there was nothing mysterious, technical, exclusive or prescribed about the care and attention that characterises an effective therapist: client relationship. It is fundamentally ordinary. The paradox is that although ordinary it is also intensely special, and any attempt to prescribe it is a corruption of reality and doomed to failure. A further paradox is that it cannot be taught either. The psychotherapy training programme he devised in Cambridge embraces this practical and ethical dilemma. He talks a little about this in Cultivating Intuition and in the present book some students of the programme get the opportunity to reflect on the experience.

In his latest book (1999) he extends his previous work arguing that therapists become dependent on the technical aspects of their profession at the expense of the many moral issues like the use and abuse of power, and he explores the dilemmas involved when there is a clash of moral beliefs between two people. This avoidance of the moral issues in the cause of spurious scientific neutrality means that the dialogue between the therapist and patient tends to be distorted, potentially confusing, and too remote from the healthy reality of ordinary conversation, and may hinder rather than help the healing process. What Lomas has done in his life's work is to combine the dynamic conception of psychoanalysis with an existential ethical regard for the person as experiencing being. As such he occupies an almost unique position within the British therapeutic tradition and can be thought of as an originator of the existential perspective. His writings are as relevant today as the day they were written and he deserves to be read more widely. This particular book although interesting for Lomas scholars, is not as rewarding a read as going to the original works which are as fresh now as when they were written.

Ian Owen