In 2007, Mick Cooper and John McLeod published a paper proposing a ‘pluralistic framework for counselling and psychotherapy’. By 2011, this framework had evolved into an approach with a few ‘pluralistic therapy’ trainings offered in the UK and Ireland; and by 2018 there was sufficient impetus to launch the first annual international conference on pluralistic therapy in Dundee, Scotland.
This evolution from framework to modality has engendered a certain amount of confusion, most noticeably around the issue of whether ‘pluralistic therapy’ is anything new or just ‘integrative therapy’ under a different name.
Before pluralistic therapy, there were pluralistic philosophies. For those interested in the potential of pluralistic approaches these philosophies need to be, at least, basically understood to see what, if anything, differentiates pluralistic therapy from integrative therapy.
Pluralism goes back to the pre-Socratic Greek philosophers and continues to interest philosophers up to the present day. There are a myriad of philosophers who have articulated pluralistic positions: those most relevant to the concept of ‘pluralistic therapy’ include William James, Emmanuel Levinas, and Nicholas Rescher.
Rescher’s view that ‘any substantial question admits a variety of plausible but mutually conflicting responses’ is often cited to back up a central claim of pluralistic therapy that it is more important that the appropriate therapy is delivered to the appropriate client at the appropriate time than it is to believe that one type of therapy is always and for everyone the superior ‘treatment’ – the basis for most therapy research and provision in the UK public sector.
The pre-Socratic Greek philosophers belonged to seven different schools. These schools included Empedocles of the ‘Pluralist’ school and Democritus of the ‘Atomist’ school – the latter making some impressive guesses about atomic theory. Some see these two schools as belonging together as both share a belief in ‘substance pluralism’. This was the view that there were lots of different substances in the Universe which contrasted to an opposing view that everything was made up of one substance which was the view of the philosopher Parmenides. Applying this to therapy we might wonder if there is one therapeutic substance to which all therapists should aspire, or should we have lots of different substances? Should we only have ‘evidence-based’ substances? Or maybe some worthwhile substances cannot be evidenced. For instance, the ‘relationship’: should this ‘substance’ be treated as an irrelevant ‘placebo’ effect when randomised controlled trials are attempting to isolate the effectiveness of other substances such as a particular therapeutic approach?
For me, the most relevant philosopher in relation to pluralistic therapy is William James. His last published work, A Pluralistic Universe (1909) is not very well known. But, the book is based on lectures which James gave at the University of Oxford, and they attracted ‘an audience far larger… than any philosophical lectures given before in Oxford’.
James celebrates the ‘some’ and the ‘might’ of pluralism over the ‘all’ and ‘must’ of monism. It is easy to perceive how monistic attitudes affect the audit-driven and shallow research of current therapy provision and providers. The pseudo-scientific cultures which act as gatekeepers of influence and provision so often reflect what James called ‘bugaboo’ empiricism rather than his ‘radical’ empiricism also known as pluralism.
Since Cooper and McLeod first articulated their pluralistic framework the reception by therapists has been mixed but, curiously perhaps, the most defensive position has come from some voices within the person-centred community.
The biggest and most common misconception, in my view, is that pluralistic therapy is the same as integrative therapy.
Pluralism is best understood as a process rather than an ‘endpoint doctrine’ to believe in: a verb rather than a noun. Pluralism, properly understood, cannot favour integrationism over purism. Pluralism as a philosophy is certainly not bothered about the importance of finding ‘common factors’ between different therapeutic approaches, rather it accepts ‘dissensus’ as the way things are even if we would prefer it otherwise. And in that acceptance there is also a parallel process of celebrating the rich tapestry of therapies even within strongly held disagreements. Because another central assumption is that we also accept that even our most strongly held views might be wrong and ‘the Other’ could be right: ‘Pluralism… is a name for staying with the feeling of and, of but, and if and with; for staying with the one and the many…’
On a pragmatic level – and there are parallels between pragmatism and pluralism – ultimately, pluralism in therapy could be the basis for a political movement encouraging a diversity of provision and providers in public health rather than yet another brand of therapy in the marketplace.
Jay Beichman, PhD has been practising as a therapist for over 20 years. In 2019, Jay was awarded a PhD in counselling and psychotherapy from the University of Brighton.