On January 7, The Guardian published an article by Oliver Burkeman, "Therapy wars: the revenge of Freud", discussing the many differences between psychoanalysis and Cognitive Behavioural Therapy.
Our President, Nick Temple, wrote a letter to the editor in response to Burkeman's article. It was too long to publish, but we have decided to release it in full here.
Oliver Burkeman’s article ‘Therapy Wars’ (Thursday 7th January) in the ‘Guardian Journal’ takes an important step in countering a trend in mental health services, which has seen psychoanalytical therapies being regarded as outmoded and lacking a broad evidence base, while CBT has been promoted as the psychological treatment of choice in the NHS.
He portrays Freud and psychoanalysis as consigned to the dingy basement of psychology, but this is a misleading picture - especially in view of the active field of innovative psychoanalytic work in this country. It is sadly true that, following Layard’s IAPT initiative, many senior psychotherapy posts in the NHS have been lost and replaced by CBT therapists with limited experience. This has denuded the NHS of many expert psychotherapy departments which had previously taken years to develop. It has also led to a reduction of the number of senior specialists in internationally recognised centres like the Tavistock Clinic. In some cases, CBT has unfortunately been used as a cost saving measure, which has been detrimental to the provision of psychotherapy for patients with complex mental health problems.
Burkeman points out the limitations of CBT especially for certain kinds of chronic mental health problems. The use of CBT as the universal approach in the NHS seems to represent the belief that psychological treatments do not require highly experienced specialists.
He describes the Tavistock depression study, which has demonstrated the strong efficacy of psychoanalytical psychotherapy in treating chronic depression and the long lasting effects of the treatment. This rigorous randomised controlled trial, refutes the view that psychoanalytical treatment is not effective.
The great success of Stephen Grosz’s book “The Examined Life”, with its sensitive accounts of psychoanalytical treatment, also indicates how many people are looking for thoughtful help with psychological problems, rather than quick answers. For people who are looking for psychoanalytic help, the London Clinic of Psychoanalysis continues to provide a low-fee service supported by charitable means.
I hope that this informed debate that Oliver Burkeman has initiated will continue to enable a balance between the value of CBT as a brief intervention and psychoanalytic treatments which successfully address more deep seated and longstanding psychological problems.
British Psychoanalytical Society