My Psychoanalytic Story: with Christopher Clulow

Niamh: Tell us your name, where you’re based, and as much about your professional background as you’d like to share.

Christopher: My name is Christopher Clulow. My professional base for the past 50 years has been an organisation now called Tavistock Relationships. I am a consultant couple psychoanalytic psychotherapist, a Senior Fellow at the Tavistock Institute of Medical Psychology (the registered body of Tavistock Relationships and forerunner of the Tavistock Clinic) and a Fellow of the Centre for Social Policy. There are a few other roles I have, but that gives you an idea.

My professional background, as for many people coming into psychotherapy, was social work. I was finishing up an economics degree at Exeter University when I met my wife, so I was looking for a means of staying on. I had a helpful tutor that put me in touch with an organiser of the Postgraduate Certificate in Social Work training at Exeter, so I went on that course. I knew I wanted to work in a field that involved people and meanings, and this was like discovering the right kind of world for me. I trained in a number of placements and one of them was with the probation service. My first job was as a probation officer, and I worked as that for five years in Dorset.

Probation and social work were very interesting at that time because psychodynamic social casework was informing practice. I had a terrific supervisor who helped me think about offending behaviour in a family context, and as acting out – communicating things that couldn’t be put into words. At that time probation offered a voluntary matrimonial service. If a husband or wife turned up in court over the weekend complaining about their relationship they would be sent to the probation service to have things sorted out. There’s an interesting historical and, for that time, logical link between probation and marriage: because divorce was perceived as deviant social behaviour and granted only after a ‘matrimonial offence’ had been proved, a service for offenders (probation) was tasked with undertaking divorce court inquiry work.

Douglas Woodhouse, the chair of the Institute of Marital Studies (IMS) – this is what Tavistock Relationships was then called – came to Dorset occasionally to run seminars for probation staff. I attended one of those. That’s how I got to know about couple and family work at the Tavistock Centre. So at 28, when a job became available, I applied for and was employed as a ‘caseworker’. It wasn’t until the 1980s that we changed our title to ‘marital therapist’ when therapy was becoming part of the lexicon. Then, because of other things that were happening in the environment – people co-habiting, same sex relationships and so on – ‘couple’ replaced the word ‘marriage’. So, the 1990s saw the title change to ‘couple psychoanalytic psychotherapist’, which is what graduates at Tavistock Relationships are now called.

I spent a large part of my career in a managerial role at Tavistock Relationships, starting in 1980 when I became Deputy Chair, elected by the Staff Group. Janet Mattinson – who was one of my tutors at Exeter – became Chair. When she retired in 1987, I was elected to succeed her. I stayed in that role (the title later becoming ‘Director’ signifying a change in the direction of accountability) until 2006, and that’s when I stood down. I’ve been working in private practice ever since.

Niamh: What was the change like from social work to therapy? I imagine some aspects are similar whilst others are very different.

Christopher: Towards the end of my time in the probation service, I was involved in a Home Office research project. Dorset was one of a few selected areas where a number of probation officers were given smaller caseloads to see if intensive work would make a difference to re-offending rates. That whetted my appetite to work with a small number of people and more in-depth. I was interested in linking clinical practice to research and training. The IMS was one of the few organisations that combined these activities in one job – being a clinician as well as providing training for a range of practitioners and undertaking clinical and action research. It made sense to think about how to improve services through working with people who were providing them. It’s not like I saw this beacon and knew I wanted to be a psychotherapist, but opportunities came along, I gave them a try, some things fitted and some things didn’t, but I sort of found my way.

Back in the mid-70s the Tavistock Centre was an exciting place to be. Work and ideas crossed departmental boundaries. I was supervised by Enid Balint amongst others, an independent analyst credited with founding the IMS. There were people like John Bowlby in the building (who wrote the foreword to my first book) and Colin Murray Parkes was just down the corridor developing the hospice movement. Ronnie Laing wasn’t there, but he was to be found in Hampstead pubs at that time, and occasionally gave talks.

Niamh: Between working with individuals, families and couples – did you gravitate to one of these groups or did they all remain within your practice up until the end?

Christopher: My clinical practice has been more or less exclusively working with couples. But other work has interested me in family organisations. The first research project I was involved with was on the transition to parenthood, working with health visitors and looking at couples and their experience of becoming parents. We also did an action research project with family court welfare officers in London in the 1980s, looking for opportunities to mediate between divorcing partners in conflict about what should happen with their children. We thought that in the course of preparing inquiry reports there might be opportunities to help parents arrive at their own solutions rather than have courts make the decision for them. So, transitions for partners becoming parents, and those in and out of marriage, was part of my work.

Niamh: It would be interesting to know more about your relationship with confidence throughout your career. Was there a defining moment? Or has your confidence grown over time, if at all?

Christopher: I think it’s been one of those growing things, because I don’t think I was a confident practitioner. I couldn’t quite believe people saying: “Well, this has been helpful.”

If I was to answer your question in theoretical terms, I think every therapeutic approach focuses on three things, but they receive different emphases. One is cognition – how people think. One is affect – how people feel.  The other is behaviour – how people act. I started out my career by looking at how people act, their behaviour. Then I think I got into my head in the early years. Ideas appealed to me, and my emphasis was on cognition, trying to understand things. Now I think affect is the key, that’s the driver. The main point of any psychotherapy exercise is to establish a relationship in which you’re involved with other people. You won’t know where it’s going, or necessarily whether and how it’s going to help. I think the point of interpreting is to help people contain their emotions. I think containing affect is the principal thing, and certainly in my practice I think I’ve learned that feeling safe is a precondition for learning. Perhaps this accounts for my interest in attachment theory. Everyone needs a safe haven on occasions; we all need our defences. I’m a great respecter of people’s defences. It’s only when you’ve established a sense of safety in a therapeutic relationship that exploratory work is possible. Often the big steps forward follow from recovering from when you’ve got things wrong. We’re all human, after all, and I think that acknowledging fallibility is very, very important.

In some respects, I’m a bit of an outlier. I’ve been quite happy to be working from the outside in. In my professional career I’ve located myself more on the outside than the inside. I’ve got more internal as the years have gone by. As a manager, I was very committed to sustaining a network of relationships outside the organisation. I was involved in building international and domestic networks to safeguard and develop funding. One of the dilemmas for me was that as I worked on the outside, there were many developments on the inside of the organisation. With registration came the first clinical training in psychoanalytic couple psychotherapy, along with publications that put couple work very much into the psychoanalytic world. In my position, I experienced some tensions between developments in the internal and external worlds of the organisation.

At some level that’s the bread and butter of couple work: tension between internal and external. The insights that people bring, their assumptions, convictions and beliefs about relationships and life, all of these come into a relationship. I feel during this century that I’ve grown in terms of confidence and in my enjoyment of psychotherapy. When I was a manager, there were times when I knew I wasn’t fully present in sessions; I was worried about other things. It could be really hard. We had an edict that everybody should be involved in all three activities: clinical, research and training. That was quite a big ask, and if you add management on top of that I found it a bit overwhelming. There were times when I felt estranged from my colleagues and they from me. We had our difficulties, as one does in organisations.

I’ve written a lot over my time. I’ve got a dozen books with my name on the title, and over 160 other publications. Recently I stepped down as Editor-in-Chief of the journal Couple and Family Psychoanalysis, although I’ve stayed on the board as an editor. I’m still interested in writing and bits of teaching, especially about what might travel from consulting room wisdom to help understand the awful state the world is in at the moment, and I remain an active trustee of a local charity offering free psychodynamic individual and group therapy for young people. But I think it’s good that I no longer have the regular commitments required by clinical work and supervision. My wife and I have grandchildren, I play a bit of jazz and tennis. While I can still be actively involved in these things it’s nice to be able to do so.

Niamh: It’s interesting to hear about these professional moments of change. For anyone involved those moments of change, it must be really hard but especially from an organisational perspective.

Christopher: There’s an irony here. We therapists, like everyone else, find change difficult, but we’re in the business of effecting change, and that can be a tough dilemma. The changes that have affected couples, and the opportunities to help couples change, have been things that have grabbed my attention. My PhD was on the basis of published works and entitled ‘Couples in Change’, a pretty broad subject that gathered together a range of different things I’d been interested in.

In terms of development as a clinician, I think I’ve been interested in learning what it is that helps people change. I think the critical component is how people feel about themselves and others. The more available you are, the more likely it is that emotional connections will follow. I’m sort of getting the hang of psychotherapy now as I head into retirement!

Niamh: Moving from the theme of change to resolution or conclusion. I wonder what your relationship is with endings as you wind down your career?

Christopher: Yeah, it’s been a big dilemma for me, trying to find the right time. I’m sure I could carry on for a few more years seeing couples, and I would enjoy it. But on balance, I think it’s better for me to quit while I’m ahead – especially while I’ve still got something of a memory! I’m aware that time is precious, so thinking about how to spend it has become increasingly important. I think it’s the right time for me to face not being what I’ve been all my life. That will be a change!