Book Review: The Black Mirror: Fragments of an obituary for life

The Black Mirror: Fragments of an obituary for life

Raymond Tallis. (2016). London: Atlantic Books.

Tallis, philosopher and retired professor of geriatric medicine, approaches the topic of mortality from the perspective of viewing his own corpse, using its inert Nothingness to illuminate the Everything of human existence. His focus is on the basic elements of life, to remind himself and us of the everyday richness and wonders of being alive and the necessity to remember and be grateful more often.

This book is a hymn to life, to be fully awake and make the most of it, to avoid dissipating what we have in order not to look at what we will lose. He describes and celebrates all the amazing aspects of embodiment (those facilities we take for granted until, as Rabbit describes, they gradually fade with age). We die because we are 'improbable', our wonderful highly structured bodies are at odds with the general tendency of things to entropy.

He begins by looking unflinchingly at his imagined corpse. He suggests that seeing life from this perspective brings us to the heart of the philosophical impulse, making us onlookers into the strangeness of our being in the world. He 'sees' his corpse being laid out, mourned over by those whose memories of him will constitute whatever afterlife he can hope for, heading into the crematorium fire which he has chosen over the worms. Then he steps back to consider the living body: pumping heart, lungs, bowels, kidneys and so on, 'a constellation of miracles' (p 39).

He then widens out to look at the elements we are made of and intimately connected to, and our senses which transform the world around us. He remembers the smell of a newly mown lawn, wood smoke, singed hair, urine in public toilets; and so on through sights, sounds and touch, describing some of the things that have intrigued, repulsed and delighted him.

Then he moves to the world with others. Relationships, modes of behaviour and dress, the social mores of his community and the cultivation of a carefully constructed identity. His world of work, the 'tools' of his trade, his hobbies, all the things that had interested and enthralled him, constituting a full and busy life.

He recalls his hoard of possessions, his 'empire' (the stuff we all accumulate that marks stages and events in our lives and bolsters our sense of a substantial self) poignantly contrasted with the few possessions (a rubber bone, basket and blanket) of his long-deceased dog, blissfully content with so little. Then the experience of moving from a house long inhabited and felt as 'home' and seeing how when empty it was disturbingly revealed as a temporary stage set, a premonition of a world carrying on without him.

Tallis is a kindly and thoughtful companion in this exploration of the view through the black mirror, a journey that is hard to contemplate with eyes wide open, but he makes it possible and worth the effort. He uses himself as an exemplar but of course it's about us all.

Then awakened by death…relish that it is still possible to put the kettle on, look out of the window, and exchange smiles with another human being

(p 344)

Helping Beyond the 50-Minute Hour. Therapists Involved in Social Action

Jeffrey A. Kotler, Matt Englar-Carlson & Jon Carlson (2013). New York: Routledge.

Should Psy-professionals Be Political?

I began writing an outline for this review while still reading the book. I thought it would save time. However, chapter by chapter, my impressions changed considerably. The constant edits of the first sentence conveyed the shifts in my experience: 'This is a very accessible and inspiring book, I think most therapists would find it valuable…', 'Although a book like this is important in the field, the case studies here are somewhat repetitive and I am not sure how much of the content will challenge or edify most readers of EA …', 'The moving accounts of therapists working outside the consulting room broaden the scope of what it means to be a therapist'…

Having completed the book, I would now say:

Helping Beyond the 50-Minute Hour is written with humanity, humility, and insight. Each author has made a point of piercing the self-aggrandising language of psychotherapy literature. This is a book of personal stories, of 'professionals' working with communities and groups, putting political values into action, expressing with integrity the concerns that have developed from each author's unique life experiences. It is written in the first-person and most chapters have photographs of the authors in context.

In the preface, the editors outline the perspective that grounds the book, 'helping professionals have a moral obligation not only to work on behalf of our own clients, but also on behalf of those who have been neglected and ignored'. They believe their training in 'systemic interventions, group dynamics, cultural competencies, relationship skills, and therapeutic interventions' make them ideally suited to effect positive change with marginalised groups who would otherwise have no access to services.

Most chapters describe experienced therapists' frustrations with the limited impact of the one-to-one therapy situation, and how this frustration encouraged them to become active outside their paid work. Other accounts are about working in charitable agencies or about therapy trainees and their experiences in developing countries or deprived communities. The book is written by American therapists and so some details or attitudes may come across as culturally specific, but this won't impinge on the usefulness of the book for a UK audience.

It is totally naive, though not uncommon, to claim that psychology and psychotherapy can be 'neutral' in terms of politics. 'Neutral' usually equates to unacknowledged alignment with the prevailing power structures of the state. This alignment can seem so 'reasonable'. It secures closed-shop

restrictions on practice, well-paid employment and influence in statutory institutions, high university fees to compensate for government underfunding, all working to keep the profession exclusive to a mostly white middle class trainee with conventional attitudes to the social structure. Recently we have seen in the UK the darker side of our professional collusion, controversies over IAPT, and sanctions on the unemployed who resist 'mental health' intrusion into their lives. These recent excesses seem to have alerted psy-professionals to the costs of taking a 'neutral' compliant attitude towards the neo-liberal doctrine. Recent moves in the profession (the Psychotherapy and Counselling Union, Psychologists against Austerity, etc.) suggest that many of us are ready to accept the inevitable political nature of our profession.

I had hoped to see some analysis of these intersections between state and profession in the book but that is not its focus.

Why have I come around to recommending this book? The main reason is that it provides a consistent challenge, through descriptions of practice, to the stance that psychologists should not reveal anything personal about themselves. These authors do not hide their politics, they question our tendency to 'individualise' distress and not see it as a symptom of social inequality. We might add to that our resistance to look at the psychological impact of powerlessness upon whole communities, and how our lack of democracy and transparent power structures, are in themselves a major cause of distress.

The book is divided into five parts: Revisioning Clinical Practice, The Dreamers: What Change Could Be, Community Action, Global Outreach, and Closure and Reflection. Each part has a number of chapters covering various aspects of the topic. Many of the authors come from a Christian background though this is mostly incidental and was not off-putting to a non-Christian reader like myself.

One of the authors, William J Doherty, says 'Its time to create a new professional role for ourselves: the citizen-therapist for the 21st century – an agent of change, not just a critic of what isn't changing. Unfortunately our trainings have done little to prepare us for this role'. Citizen-therapist work can be done in about 6-8 hours a month, not a huge time commitment. Doherty says that as a young graduate in the 1970s he believed 'in a kind of "trickle up" psychological dynamic, whereby therapy would make enough people healthier to tilt the social order toward justice and harmony' (p 15). He has since abandoned that passive model for the more active stance illustrated in the book.

The steps towards expanding your practice into community and political contexts are described as: 1. Ask which clinical issues grab your interest most. 2. Start seeing these personal problems you treat within their larger social context. 3. Connect with a fellow therapist with whom you can share your journey, and then find a community of allies. The assumption here is that 'all clinical problems treated by therapists are thoroughly interconnected with larger public issues…' (p 17).

Some of the chapters concentrated on working in inner city counselling centres in a way that I feel would be quite familiar to many of us who have at least had placement opportunities in local community organisations. Authors make the case for including in our training 'social and class consciousness' and classes on how to link to local resources and expand counselling to include resource and information sharing. They advocate that trainees learn about active deconstructing of social messages that determine who you are and what you can be, based upon socio-economic group, ethnicity, sexual or gender identity…. Some of the chapters sound more like social work, community advocacy work, youth work…

In Codrington's chapter on social justice counselling, she points out that Psychology has never been a-political – it promoted eugenics in the early 1900s and had an active part in the CIA abuse and torture of detainees in US military installations. We are always being political but usually fail to name this. 'Value-free neutrality' is a political agenda and one that has not served us, or our clients, well. We need to raise our consciousness of such things and of course the first place this should occur is in our training, including lectures and how we are supervised. The intrapsychic fallacy of distress, which has never been existential anyway, needs to be met with a well-thought-out alternative.

There are chapters describing work with veterans trying to reintegrate into society, a fast response team of counsellors and supervisors working in post-Katrina New Orleans, a Buddhist psychologist working in her native Thailand after earning her doctorate in the US. I liked the chapter describing facilitating peace-building and leadership workshops with women in Burma. The Burmese women in the group decided they were not sure they wanted their organisation to be 'democratic': 'In a democracy, people's voices get left out. Small groups of people who are not part of the mainstream are not represented. We have lived in a dictatorship – a totalitarian system. We want something better than "democracy"!' (p 227). Chante DeLoach's chapter describing working as a psychologist in the aftermath of the Haiti earthquake was perhaps the most moving account, showing how preconceptions of what constitutes 'competent practice' can be stretched beyond recognition in certain settings.

In the final section of the book, Closure and Reflection, Kotler says 'It is a given that we became therapists in the first place, and got involved in social justice and service, because we want to save the world. We want to make a difference. We believe strongly in advocacy, and working on behalf of the marginalised and oppressed. We feel a strong commitment to make things better for our communities – and the world at large'. But he balances this idealism (which may or may not resonate with us) by also describing

Diana Pringle