When I was asked to write about my experience on the forensic psychotherapy course run by the Portman Clinic, it was with some anxiety that I agreed to the task. I strongly felt a need to share my experience with prospective students in order to encourage them to persevere with the training. How to achieve this goal without appearing critical of my colleagues in the group, or rejoicing in their difficulties, was the cause of my anxiety.
I joined the course as a psychiatric trainee without much previous knowledge of the psychotherapy field. I hope to convey the initial feelings of insecurity and self-doubt which I felt particularly in the first year of the course, and to relate how my medical and scientific background helped me in the second year.
The emphasis in the first year of training was on the clinical application of psychodynamic principles which the organisers of the course apparently assumed were possessed by the new trainees! Indeed such knowledge, it seemed, was familiar to some of my colleagues and that only served to heighten the sense of inadequacy that I felt. The language was strange but, I struggled along. Thankfully with the support of the group I successfully completed the first year.
The second year was another matter. The emphasis was now on the trainees to develop an understanding of basic principles such as the unconscious, transference and counter-transference etc. This understanding was not to be based on an uncritical acceptance or faith in what the idealised lecturer is propounding but on a challenging appraisal of the material. My scientific background and the so called medical model I realised were useful in coming to grasp these concepts. The idea that psychodynamic principles were themselves open to critical analysis was an eye opener. They were not articles of faith of some religion, written on stone tablets and brought down from the mountain top by 'the' prophet!
The realisation that some of my colleagues in the group found this approach difficult and apparently unsatisfying came somewhat as a surprise to me. On further reflection it made me realise that 'truths' which are given but not arrived at or reinforced by further reflection have little substance.
The tendency towards idealisation of significant figures in the psychotherapy field, and an unwavering belief in their pronouncements, while helpful in some ways, may not do much to further true learning. Some scepticism and an attitude of 'looking at it anew' may be helpful. An awareness that one does not know need not create a sense of inadequacy; it is the foundation for learning.
The fact that the organisers of the course have now decided to move the course content of the present second year to the first year is good news. It should help all trainees to develop together without shaking the faith of some, or making others feel insecure.