The Values of Psychotherapy1

This is a wide-ranging book which will be of great interest to psychoanalytical psychotherapists — most especially those working in the public sector. It results from a fruitful collaboration between a psychotherapist (Holmes) and a philosopher (Lindley). It addresses fundamental issues that lie at the core of arguments concerning psychotherapy: there are chapters on the epistemological status of psychotherapy; the case for psychotherapy as a need and not a luxury; ethical issues in connection with the practice of psychotherapy; and the case for a psychotherapy profession.

It is the kind of book that psychotherapists might turn to to clarify their thinking, and also one which they might give to friendly managers who want to back up their case for expanding psychotherapy services. For this the authors are to be congratulated.

The core of the book rests upon the authors’ view that the central value of psychotherapy rests in its capacity to increase personal autonomy: freeing people from the internal factors that inhibit personal development. I think the authors present a strong case, although some of the philosophical details are not without their difficulties. has argued against the authors’ derivation of their ideas from the work of J S Mill (namely the utilitarian perspective).

In the first pages of the book the authors give a very broad definition of psychotherapy which covers psychoanalytic psychotherapy, family therapy, cognitive psychotherapy, and behavioural modifications — though the last seemed to me to be a bit forced. This broad definition serves to find a common denominator in all these approaches, but given the differences between these therapies, this common denominator is more of the lowest common denominator type. Flynn (namely the utilitarian perspective) has argued that the resemblances between therapies may be no more than ‘family resemblances’ (a term used by Wittgenstein)2. Whether the similarities between them ‘would be considered central or essen