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Joint CPN & SAFPAC Annual Online Conference
Psychotherapy Without Therapy:
Rethinking the purposes of therapeutic practice
Saturday 26th September 2026
9:30 am for 10:00 to 5:15pm
Zoom link to be sent after booking
Speakers include: Talha AlAli, Nicole Chew-Helbig, Stephan Dietrich, Katja Kurri, Alex Lambert, Del Loewenthal, Helen Moss, Chris Oakley, Timo Sampolahti, James Sedgwick, Keith Tudor, and Paul Wadey
£15 waged £5 unwaged
£10 SAFPAC Clinical and Associate Members & CPN Members
Click here to book tickets
In the early decades of the 21st century, psychotherapy finds itself at a critical juncture. While the language of wellbeing, resilience, and evidence-based outcomes dominates public discourse, many practitioners experience a tension between therapy as management and therapy as encounter. Are psychotherapists increasingly socialised to normalise individuals – to adjust clients to the demands of a neoliberal, digitised society – rather than to question or transform the conditions that give rise to distress?
The digital revolution and the rise of artificial intelligence are reshaping the psychic and relational worlds of clients. At the same time, are psychotherapists – often trained in more liberal and humanistic eras – now practising within systems marked by surveillance, performance metrics, and risk management? Doesn’t, increasingly, the confidential, exploratory space of psychotherapy risk being replaced by a culture of accountability and compliance?
As one commentator remarks, ‘In today’s market, we find a whole series of products deprived of .. [ what is seen as]. their damaging properties: coffee without caffeine, cream without fat, beer without alcohol’, so do we now have Psychotherapy Without Therapy? Further, as we move from a liberal society, is the experience of the majority that their ‘individuality is gradually being dismantled’ such ‘they loose their integrity’ and become ‘like jelly’? Does this lead to a further self-defeating need to maintain composure and function at all costs, not only from, as another commentator argues, ‘pills or other addictions but also relationships with therapists’? Consequently, as psychotherapists are we, more than in danger of being, in the business of tranquillisation and socialisation and if so ‘to which dominant society’?
This conference invites participants to consider whether psychotherapy has become Psychotherapy Without Therapy - a set of techniques detached from its ethical, political, and philosophical roots. Should psychotherapy recover a more radical, reflective, and socially engaged voice ? Are there examples where it has? What does that/ could that/ would that/ look like in today’s “liquid modernity,” where both therapists and clients navigate shifting cultural, economic, and technological conditions?
Submissions have been invited to this conference to address questions such as:
- Can psychotherapy still be radical – or has it been domesticated by neoliberal structures emphasising individual responsibility where distress is framed as personal impairment and not a response to inequalities; and, where clients are encouraged to ‘work on themselves’ with the danger that therapy becomes about adaptation to, rather than challenging, societal oppression?
- Are psychotherapists managing their clients’ states rather than engaging in psychotherapeutic work?
- What are the limits of confidentiality and freedom of speech in contemporary practice?
- How do changes in patterns of work, identity, and belonging shape the psychic suffering clients bring?
- Can practitioners trained in liberal traditions provide psychotherapy in a neoliberal world?
- What ethical and political responsibilities arise from these tensions?
- Are psychotherapists primarily normalising clients so they self-regulate internalising and conforming to the behaviours, values, and attitudes that a society defines as “appropriate”.
- How do digital technologies and AI adversely affect the psychic lives of clients and the work of therapists?
- What culture or ideology do psychotherapists implicitly socialise their clients into?
The idea of this conference is that there will not only be speakers reporting on the cutting edge of such questions regarding Psychotherapy Without Therapy; but, there will be space where participants can explore in small groups how this may be experienced both as opportunities and challenges by psychotherapists as well as their clients/patients.
Prof Del Loewenthal
Conference Chair
Critical Psychotherapy Network &
Southern Association of Psychotherapy and Counselling
PROVISIONAL PROGRAMME
9.30am - 10.00am: Zoom log in
10.00am - 10.05am: Welcome, Prof Del Loewenthal - Conference Chair (Critical Psychotherapy Network and Southern Association for Psychotherapy and Counselling, UK)
10:05am – 10:20am: Introduction: Psychotherapy Without Therapy: Rethinking the purposes of therapeutic practice, Prof Del Loewenthal - Conference Chair (Critical Psychotherapy Network and Southern Association for Psychotherapy and Counselling, UK)
10:20am – 10:40am: Hidden in Hidden in plain sight: Reflections on overcontrol in the therapy room – Alex Lambert (Nottingham Trent University, UK)
10:40am - 11:00am: Psychotherapy Without Therapy: A Decolonial Re-Reading of Healing, Power, and Social Justice – Talha AlAli (Decolonised Minds Ireland, Ireland)
11:00am – 11:10am: Break
11:10am – 11:30am: Shame as the Last Human Frontier: What AI Cannot Provide and What Therapists Must Not Forget – Nicole Chew-Helbig (Gestalt Singapore Pte Ltd, Singapore)
11:30am – 11:50pm: Unshaming Distress: Psychotherapy as Encounter– Helen Moss (Private Practice, UK)
11:50am – 12:00pm - Break
12:00pm – 12:30pm - Response 1 – Keith Tudor (Aukland University of Technology, New Zealand)
12:30pm – 1:10pm– Small Groups
1:10pm – 1:50pm – Lunch
1:50pm – 2:10pm - Disorders of Possibility: Describing a contemporary form of distress – James Sedgwick (Birmingham Newman University, UK)
2:10pm – 2:30pm - Psychotherapy research and its discontents – navigating in the riptide of practice, politics and values – Timo Sampolahti & Katja Kurr (Private Practice & University of Jyväskylä, Finland)
2.30pm – 2.50pm: Exposing Knowledge in the Therapeutic Encounter: Epistemic Disturbance and Therapeutic Responsibility – Stephan Dietrich (Österreichisches Daseinsanalytisches Institut, Austria)
2.50pm - 3.00pm: Break
3.00pm – 3:20pm: The Bricoleur in the Consulting Room: Improvisation, Uncertainty, and the Ethos of Therapeutic Presence – Paul Wadey (Institution, Country)
3:20pm – 3:50pm: Response 2, Chris Oakley – (Private Practice & Site for Contemporary Analysis, UK)
3:50 – 4:00pm Break
4:00 – 4.40pm: Small groups
4:40 - 5:15pm: Plenary, Presenters, respondents, and all participants
5:15pm: Conference close
SPEAKER ABSTRACTS AND BIOS
Talha AlAli - Psychotherapy Without Therapy: A Decolonial Re-Reading of Healing, Power, and Social Justice
In this presentation, Talha argues that contemporary Western psychotherapy is increasingly at risk of becoming psychotherapy without therapy: a practice that retains the form of care while losing its ethical, relational, and political substance. Drawing on decolonial theory, critical psychology, and historical analyses of healing, the paper challenges the assumption that psychotherapy is a uniquely modern European invention and traces how pre-modern and non-Western traditions, while not treated as a singular or homogeneous category, understood distress as embedded in meaning, community, and ethical life. Against this background, the presentation examines how industrial capitalism, neoliberal governance, audit culture and market logics have shaped psychotherapy into a measurable, commodified service oriented towards symptom management, normalisation, and functional adaptation. Rather than operating neutrally, such practices risk functioning as technologies of containment that absorb the emotional consequences of structural injustices while leaving the underlying causes intact. This orientation produces epistemic harm by mislocating suffering within individuals and returning clients calmer, more regulated, and more compliant to harmful conditions. The presentation argues that decolonial, pluralistic, and social- justice oriented approaches are not optional supplements but ethical necessities if psychotherapy is to remain a space of encounter rather than governance, and therapy rather than its simulation.
Talha AlAli is a Palestinian psychotherapist, human rights activist, and founder of Decolonised Minds, a platform dedicated to culturally grounded and politically conscious approaches to mental health. He holds postgraduate degrees in pluralistic counselling and psychotherapy, psychology, and community mental health. With nearly two decades of clinical and humanitarian experience, he has worked across Palestine, the Middle East, North Africa, Eastern Europe, Bangladesh, and Ireland, supporting survivors of war, torture, displacement, and structural violence. Now based in Ireland, his work integrates trauma-informed, culturally responsive, and justice-oriented practice. His research and writing draw on decolonial and liberation psychology to critically examine the ethical, political, and social dimensions of psychotherapy. He is the author of Decolonised Minds: When Radical Becomes Rational.
Nicole Chew-Helbig - Shame as the Last Human Frontier: What AI Cannot Provide and What Therapists Must Not Forget
The integration of artificial intelligence into mental health care has intensified debates about what must remain human in psychotherapy. While existing literature emphasises therapeutic alliance, embodiment, and presence as limits of automation, it often fails to specify why these dimensions are irreducible. I argue that shame marks the relational region machines cannot enter—and the clinical core psychotherapy increasingly risks abandoning. Drawing on a clinical case of a client who used ChatGPT alongside psychotherapy, I show that while AI can provide reassurance, emotional regulation, and cognitive support, it cannot participate in the relational field where self-image, formed through early mirroring, reorganises through present relational risk. Through Gestalt field theory and phenomenology, shame is not exhausted by the intrapsychic. It is an intersubjective event that arises through exposure in another’s presence and can only be metabolised through mutual vulnerability. AI’s limits do not lie in intelligence or empathy, but in something more fundamental—it cannot be wounded. It cannot rupture and repair. It cannot risk being changed by encounter. As psychotherapy adapts to managerial and technological pressures, it becomes vulnerable not to replacement by machines but to its own hollowing out. Shame, I argue, constitutes psychotherapy’s last human frontier and its ethical boundary.
Nicole Chew-Helbig, PhD, is a psychotherapist based in Singapore, working from a Gestalt and phenomenological field-theoretical orientation. Her research is grounded in therapeutic autoethnography, integrating lived clinical experience with theoretical reflection.
Stephan Dietrich - Exposing Knowledge in the Therapeutic Encounter: Epistemic Disturbance and Therapeutic Responsibility
Contemporary psychotherapy increasingly relies on professional knowledge, standardised guidelines, and evidence-based protocols. These developments provide orientation and accountability. Yet therapists regularly encounter situations where such knowledge proves insufficient or obstructive in the therapeutic encounter. I argue that such moments mark instances of epistemic disturbance: situations where available knowledge remains valid while losing its practical adequacy. Drawing on phenomenological and daseinsanalytic perspectives, I conceptualise epistemic disturbance as an original form of therapeutic experience emerging in encounters with singular persons and relational complexity. Far from marginal, it constitutes a central locus of therapeutic responsibility in standardised healthcare environments. The paper critically examines a common professional response: therapists stabilise uncertainty through intensified knowledge application, thereby neutralising what has emerged. I propose psychotherapy as an epistemic stress test for scientific rationality, confronting knowledge with singular persons and relational complexity. Therapeutic effectiveness lies not in eliminating uncertainty but in the capacity to expose knowledge—to hold it present without treating it as absolute. Such engagement remains essential if psychotherapy is to remain an encounter-based practice rather than therapeutic management aimed primarily at societal adaptation.
Stephan Dietrich is a psychologist, psychotherapist, training analyst, and supervisor in daseinsanalytic psychotherapy based in Vienna. Since 2024, he has served as President of the Austrian Daseinsanalytic Institute (ÖDAI). He is a lecturer at Sigmund Freud Private University Vienna and Chair of the Ethics Commission of the Austrian Psychotherapy Advisory Board. Alongside his private practice, he previously held a leading clinical position at Verein LOK, a non-profit organisation providing supported housing and psychosocial rehabilitation for individuals with severe mental illness. He studied psychology, linguistics, and philosophy at the University of Vienna. His work focuses on ontology, psychosomatics, and the philosophical foundations of psychotherapy, with numerous lectures and publications in these fields.
Alex Lambert - Hidden in plain sight: Reflections on overcontrol in the therapy room
Contemporary counselling and psychotherapy operate within cultural contexts that place strong emphasis on self-control and emotion regulation. While the capacity to inhibit impulses and downregulate emotional expression is often treated as a hallmark of psychological health, rigid behavioural control and excessive emotional inhibition may themselves constitute a clinically significant source of distress, given their empirical and theoretical links to psychological inflexibility, social isolation, and internalising difficulties. Drawing on the Neurobiosocial Theory for Disorders of Overcontrol and the emerging literature on Radically Open Dialectical Behaviour Therapy, this paper reflects on overcontrol as a transdiagnostic, culturally reinforced pattern of functioning that is frequently overlooked across clinical settings, including in therapeutic practice. The paper examines how overcontrol may present in the therapy room, why it is particularly prone to misrecognition, and how therapeutic processes may inadvertently collude with overcontrolled coping strategies. Rather than advocating for a specific intervention, the paper aims to sensitise therapists across modalities to the clinical and ethical implications of overcontrol and its associated adverse life outcomes. Finally, it offers a reflective discussion of how therapists might respond to overcontrol within their modality and considers what work with overcontrolled clients reveals about the broader aims and values of therapeutic work.
Dr Alex Lambert is a Chartered Psychologist, a Postdoctoral Research Fellow at Nottingham University, a Lecturer on the Doctorate in Clinical Psychology at the University of Leicester, and a current student of the Greenwood Counselling Academy. Her doctoral research examined the psychometric assessment of overcontrol as a rigid regulatory coping style, drawing on Lynch’s Neurobiosocial Theory of Disorders of Overcontrol. Her broader interests include the conceptualisation of psychological distress, trauma-informed formulation and intervention, and the role of social, relational, and cultural processes in mental wellbeing. This paper reflects her interest in integrating empirical theory with reflective and ethically grounded therapeutic practice.
Del Loewenthal - Psychotherapy without Therapy: Rethinking the purposes of therapeutic practice
See Conference Brief
Del Loewenthal is an existential–analytic psychotherapist, photographer, and chartered psychologist. He is a Fellow of the Royal Photographic Society, the British Psychological Society, and the United Kingdom Council for Psychotherapy; and Emeritus Professor of Psychotherapy and Counselling at the University of Roehampton.
Helen Moss - Unshaming Distress: Psychotherapy as Encounter
Drawing on gestalt therapy’s phenomenological (Perls et al., 1951) and field-based foundations (Parlett, 1991), this paper proposes an alternative stance towards distress, understanding symptoms as meaningful creative adjustments within a relational field, rather than as defects to be eliminated. It argues that therapy risks reproducing shame by locating distress within the individual, separating it from its relational and social context. Practices arising from dialogical attunement (Hycner & Jacobs, 1995) and creative, playful experimentation (Zinker, 1977) are demonstrated, offering an inherently unshaming approach, grounded in trust in embodied experience and relational support (Kepner, 1987; Frank, 2023).An invented/composite clinical example illustrates how a disowned, shame-bound part of the self can be reclaimed through embodied exploration and relational recognition. This example demonstrates how therapists might work to transform collapse and withdrawal from moral failure into intelligible responses to conditions of insufficient support. The encounter between therapist and client is understood as co-created, shaped by the field conditions as much as by individual history. The paper reclaims psychotherapy as a relational, ethical, and socially-situated practice and as resistance to "psychotherapy without therapy" (the reduction of the therapeutic encounter to regulation and symptom management).
Helen Moss is a Gestalt psychotherapist working in private practice in northern England. They hold a Postgraduate Diploma in Relational Gestalt Psychotherapy and are an accredited member of the UK Council for Psychotherapy (UKCP). Their therapeutic interests include spirituality, neurodivergence, gender and sexuality, and the relational dimensions of psychotherapeutic practice. They are committed to creating spaces for dialogue around contemporary issues in psychotherapy.
Chris Oakley – Response 2
Chris Oakley is a member of the Site for Contemporary Psychoanalysis. He works in private practice and has written extensively about a multiplicity of psychoanalytic themes. His book "Football Delirium", a psychoanalytic account of what we may be using Football to do for us, was shortlisted for the Football Book of the Year.
Timo Sampolahti & Katja Kurri - Psychotherapy research and its discontents – navigating in the riptide of practice, politics and values
The discourse surrounding psychotherapy research is shaped by ideological, political, and epistemological forces that are rarely made explicit. In this paper we examine these forces by situating psychotherapy research within its historical and ideological contexts. We argue that trends such as neoliberalism and New Public Management, which have been reshaping healthcare systems since the 1990’s, have introduced invisible currents into psychotherapy research. To illustrate this argument, we analyze three methodologically diverse articles from the 2024 issue of Psychotherapy Research. We claim that despite genuine methodological advances, the dominant research paradigm in these articles continues to marginalize both qualitative and interactional approaches and views stemming from historical and philosophical research. Furthermore, by doing so, the dominant paradigm does not merely reflect but actively produces a particular image of the human being — one defined by measurable deficits and treatable disorders, rather than by the capacity for meaning, relationship, and self-authorship that psychotherapy at its best seeks to restore. We conclude that promoting methodological diversity, fostering philosophical reflexivity, and recognizing the ethical dimensions of psychotherapy research are essential safeguards against ideologically driven narrowing of the field.
Timo Sampolahti and Katja Kurri are psychotherapists in private practice in Helsinki (integrative individual psychotherapy, couple and family psychotherapy), psychotherapy trainers, and visiting scholars in the University of Jyväskylä.
James Sedgwick - Disorders of Possibility: Describing a contemporary form of distress.
Our current Western milieu has created the preconditions for new types of suffering, including disorders of possibility. The article suggests that these difficulties can emerge in atypically capable individuals where beneficial attributes open up problematic gaps between who they currently are and who they believe they can become. Calling into question a tendency to rely upon marketisation and individualism as the means of accounting for our social malaise, an account is offered which links disorders of possibility to the intersection of meritocracy, social liberalism, democratic decline and economic uncertainty. The three key features of disorders of possibility are identified as vulnerability to shame, the instrumentalisation of the self and the reliance of life planning on a problematically restricted notion of freedom. The article concludes with a suggestion that, alongside political change, the recovery of a lost conception of freedom and a good life may be necessary.
James M. Sedgwick is a UKCP-registered psychotherapist, BABCP accredited CBT therapist and Senior Lecturer in Counselling and Psychotherapy at Birmingham Newman University, Birmingham UK. He is the author of Contextual Transactional Analysis: the inseparability of self and world (2021). He lives in Birmingham, UK.
Keith Tudor – Response 1
Keith Tudor is a Professor of Psychotherapy at Auckland University of Technology (AUT) in Aotearoa New Zealand. He has previously served as Head of the School of Public Health & Psychosocial Studies at AUT. With a career spanning over four decades across the UK and New Zealand, he is a leading figure in humanistic psychology, transactional analysis, and person-centered psychotherapy
Paul Wadey - The Bricoleur in the Consulting Room: Improvisation, Uncertainty, and the Ethos of Therapeutic Presence
'Psychotherapy without therapy' arrives, this paper argues, not when the manual enters the field but when the manual claims it. The provocation indicts not manualization itself but the monoculture under which it operates as the field's only legitimate paradigm. Against that monoculture the paper sets a calibration framing: Engineer and Bricoleur as bounded paradigmatic positions, each accountable to the other in the joint clinical task of discernment. The diagnosis is psychoanalytic before it is political. Scientism, ostensibly the field's defence of evidence, may also serve as the field's defence against evidence, since the alliance literature credits the relational conditions a manualized monoculture forecloses. The bricoleur emerges not as the Engineer's methodological alternative but as the ontological structure within which any clinical work, manualized or otherwise, becomes intelligible. What this asks of the clinician are familiar disciplines: Negative Capability after Bion and Keats, safe uncertainty after Mason, and a witnessing (Winnicott, Buber) the protocol cannot perform. The bricoleur is not what she has but what she is constituted by. The clinic that knows this calibrates; the clinic that does not, engineers.
Paul Wadey is an accredited member of the British Association for Counselling and Psychotherapy (MBACP Accred.) and has worked for over twenty-five years as a counsellor/psychotherapist, systemic family and couple's practitioner, and since 2015, as clinical supervisor, latterly in private practice. He holds a Master of Research in Psychoanalytic History from Goldsmiths, University of London, and a Master of Science in Psychology from the University of Essex. He is the author of Rhythms That Are Wrong (2025) and On Not Finding Yourself (manuscript in submission). His research interests lie at the intersection of European phenomenology and relational psychoanalysis.
9.30am - 10.00am: Zoom log in
10.00am - 10.05am: Welcome, Prof Del Loewenthal - Conference Chair (Critical Psychotherapy Network and Southern Association for Psychotherapy and Counselling, UK)
10:05am – 10:20am: Introduction: Psychotherapy Without Therapy: Rethinking the purposes of therapeutic practice, Prof Del Loewenthal - Conference Chair (Critical Psychotherapy Network and Southern Association for Psychotherapy and Counselling, UK)
10:20am – 10:40am: Hidden in Hidden in plain sight: Reflections on overcontrol in the therapy room – Alex Lambert (Nottingham Trent University, UK)
10:40am - 11:00am: Psychotherapy Without Therapy: A Decolonial Re-Reading of Healing, Power, and Social Justice – Talha AlAli (Decolonised Minds Ireland, Ireland)
11:00am – 11:10am: Break
11:10am – 11:30am: Shame as the Last Human Frontier: What AI Cannot Provide and What Therapists Must Not Forget – Nicole Chew-Helbig (Gestalt Singapore Pte Ltd, Singapore)
11:30am – 11:50pm: Unshaming Distress: Psychotherapy as Encounter– Helen Moss (Private Practice, UK)
11:50am – 12:00pm - Break
12:00pm – 12:30pm - Response 1 – Keith Tudor (Aukland University of Technology, New Zealand)
12:30pm – 1:10pm– Small Groups
1:10pm – 1:50pm – Lunch
1:50pm – 2:10pm - Disorders of Possibility: Describing a contemporary form of distress – James Sedgwick (Birmingham Newman University, UK)
2:10pm – 2:30pm - Psychotherapy research and its discontents – navigating in the riptide of practice, politics and values – Timo Sampolahti & Katja Kurr (Private Practice & University of Jyväskylä, Finland)
2.30pm – 2.50pm: Exposing Knowledge in the Therapeutic Encounter: Epistemic Disturbance and Therapeutic Responsibility – Stephan Dietrich (Österreichisches Daseinsanalytisches Institut, Austria)
2.50pm - 3.00pm: Break
3.00pm – 3:20pm: The Bricoleur in the Consulting Room: Improvisation, Uncertainty, and the Ethos of Therapeutic Presence – Paul Wadey (Institution, Country)
3:20pm – 3:50pm: Response 2, Chris Oakley – (Private Practice & Site for Contemporary Analysis, UK)
3:50 – 4:00pm Break
4:00 – 4.40pm: Small groups
4:40 - 5:15pm: Plenary, Presenters, respondents, and all participants
5:15pm: Conference close
SPEAKER ABSTRACTS AND BIOS
Talha AlAli - Psychotherapy Without Therapy: A Decolonial Re-Reading of Healing, Power, and Social Justice
In this presentation, Talha argues that contemporary Western psychotherapy is increasingly at risk of becoming psychotherapy without therapy: a practice that retains the form of care while losing its ethical, relational, and political substance. Drawing on decolonial theory, critical psychology, and historical analyses of healing, the paper challenges the assumption that psychotherapy is a uniquely modern European invention and traces how pre-modern and non-Western traditions, while not treated as a singular or homogeneous category, understood distress as embedded in meaning, community, and ethical life. Against this background, the presentation examines how industrial capitalism, neoliberal governance, audit culture and market logics have shaped psychotherapy into a measurable, commodified service oriented towards symptom management, normalisation, and functional adaptation. Rather than operating neutrally, such practices risk functioning as technologies of containment that absorb the emotional consequences of structural injustices while leaving the underlying causes intact. This orientation produces epistemic harm by mislocating suffering within individuals and returning clients calmer, more regulated, and more compliant to harmful conditions. The presentation argues that decolonial, pluralistic, and social- justice oriented approaches are not optional supplements but ethical necessities if psychotherapy is to remain a space of encounter rather than governance, and therapy rather than its simulation.
Talha AlAli is a Palestinian psychotherapist, human rights activist, and founder of Decolonised Minds, a platform dedicated to culturally grounded and politically conscious approaches to mental health. He holds postgraduate degrees in pluralistic counselling and psychotherapy, psychology, and community mental health. With nearly two decades of clinical and humanitarian experience, he has worked across Palestine, the Middle East, North Africa, Eastern Europe, Bangladesh, and Ireland, supporting survivors of war, torture, displacement, and structural violence. Now based in Ireland, his work integrates trauma-informed, culturally responsive, and justice-oriented practice. His research and writing draw on decolonial and liberation psychology to critically examine the ethical, political, and social dimensions of psychotherapy. He is the author of Decolonised Minds: When Radical Becomes Rational.
Nicole Chew-Helbig - Shame as the Last Human Frontier: What AI Cannot Provide and What Therapists Must Not Forget
The integration of artificial intelligence into mental health care has intensified debates about what must remain human in psychotherapy. While existing literature emphasises therapeutic alliance, embodiment, and presence as limits of automation, it often fails to specify why these dimensions are irreducible. I argue that shame marks the relational region machines cannot enter—and the clinical core psychotherapy increasingly risks abandoning. Drawing on a clinical case of a client who used ChatGPT alongside psychotherapy, I show that while AI can provide reassurance, emotional regulation, and cognitive support, it cannot participate in the relational field where self-image, formed through early mirroring, reorganises through present relational risk. Through Gestalt field theory and phenomenology, shame is not exhausted by the intrapsychic. It is an intersubjective event that arises through exposure in another’s presence and can only be metabolised through mutual vulnerability. AI’s limits do not lie in intelligence or empathy, but in something more fundamental—it cannot be wounded. It cannot rupture and repair. It cannot risk being changed by encounter. As psychotherapy adapts to managerial and technological pressures, it becomes vulnerable not to replacement by machines but to its own hollowing out. Shame, I argue, constitutes psychotherapy’s last human frontier and its ethical boundary.
Nicole Chew-Helbig, PhD, is a psychotherapist based in Singapore, working from a Gestalt and phenomenological field-theoretical orientation. Her research is grounded in therapeutic autoethnography, integrating lived clinical experience with theoretical reflection.
Stephan Dietrich - Exposing Knowledge in the Therapeutic Encounter: Epistemic Disturbance and Therapeutic Responsibility
Contemporary psychotherapy increasingly relies on professional knowledge, standardised guidelines, and evidence-based protocols. These developments provide orientation and accountability. Yet therapists regularly encounter situations where such knowledge proves insufficient or obstructive in the therapeutic encounter. I argue that such moments mark instances of epistemic disturbance: situations where available knowledge remains valid while losing its practical adequacy. Drawing on phenomenological and daseinsanalytic perspectives, I conceptualise epistemic disturbance as an original form of therapeutic experience emerging in encounters with singular persons and relational complexity. Far from marginal, it constitutes a central locus of therapeutic responsibility in standardised healthcare environments. The paper critically examines a common professional response: therapists stabilise uncertainty through intensified knowledge application, thereby neutralising what has emerged. I propose psychotherapy as an epistemic stress test for scientific rationality, confronting knowledge with singular persons and relational complexity. Therapeutic effectiveness lies not in eliminating uncertainty but in the capacity to expose knowledge—to hold it present without treating it as absolute. Such engagement remains essential if psychotherapy is to remain an encounter-based practice rather than therapeutic management aimed primarily at societal adaptation.
Stephan Dietrich is a psychologist, psychotherapist, training analyst, and supervisor in daseinsanalytic psychotherapy based in Vienna. Since 2024, he has served as President of the Austrian Daseinsanalytic Institute (ÖDAI). He is a lecturer at Sigmund Freud Private University Vienna and Chair of the Ethics Commission of the Austrian Psychotherapy Advisory Board. Alongside his private practice, he previously held a leading clinical position at Verein LOK, a non-profit organisation providing supported housing and psychosocial rehabilitation for individuals with severe mental illness. He studied psychology, linguistics, and philosophy at the University of Vienna. His work focuses on ontology, psychosomatics, and the philosophical foundations of psychotherapy, with numerous lectures and publications in these fields.
Alex Lambert - Hidden in plain sight: Reflections on overcontrol in the therapy room
Contemporary counselling and psychotherapy operate within cultural contexts that place strong emphasis on self-control and emotion regulation. While the capacity to inhibit impulses and downregulate emotional expression is often treated as a hallmark of psychological health, rigid behavioural control and excessive emotional inhibition may themselves constitute a clinically significant source of distress, given their empirical and theoretical links to psychological inflexibility, social isolation, and internalising difficulties. Drawing on the Neurobiosocial Theory for Disorders of Overcontrol and the emerging literature on Radically Open Dialectical Behaviour Therapy, this paper reflects on overcontrol as a transdiagnostic, culturally reinforced pattern of functioning that is frequently overlooked across clinical settings, including in therapeutic practice. The paper examines how overcontrol may present in the therapy room, why it is particularly prone to misrecognition, and how therapeutic processes may inadvertently collude with overcontrolled coping strategies. Rather than advocating for a specific intervention, the paper aims to sensitise therapists across modalities to the clinical and ethical implications of overcontrol and its associated adverse life outcomes. Finally, it offers a reflective discussion of how therapists might respond to overcontrol within their modality and considers what work with overcontrolled clients reveals about the broader aims and values of therapeutic work.
Dr Alex Lambert is a Chartered Psychologist, a Postdoctoral Research Fellow at Nottingham University, a Lecturer on the Doctorate in Clinical Psychology at the University of Leicester, and a current student of the Greenwood Counselling Academy. Her doctoral research examined the psychometric assessment of overcontrol as a rigid regulatory coping style, drawing on Lynch’s Neurobiosocial Theory of Disorders of Overcontrol. Her broader interests include the conceptualisation of psychological distress, trauma-informed formulation and intervention, and the role of social, relational, and cultural processes in mental wellbeing. This paper reflects her interest in integrating empirical theory with reflective and ethically grounded therapeutic practice.
Del Loewenthal - Psychotherapy without Therapy: Rethinking the purposes of therapeutic practice
See Conference Brief
Del Loewenthal is an existential–analytic psychotherapist, photographer, and chartered psychologist. He is a Fellow of the Royal Photographic Society, the British Psychological Society, and the United Kingdom Council for Psychotherapy; and Emeritus Professor of Psychotherapy and Counselling at the University of Roehampton.
Helen Moss - Unshaming Distress: Psychotherapy as Encounter
Drawing on gestalt therapy’s phenomenological (Perls et al., 1951) and field-based foundations (Parlett, 1991), this paper proposes an alternative stance towards distress, understanding symptoms as meaningful creative adjustments within a relational field, rather than as defects to be eliminated. It argues that therapy risks reproducing shame by locating distress within the individual, separating it from its relational and social context. Practices arising from dialogical attunement (Hycner & Jacobs, 1995) and creative, playful experimentation (Zinker, 1977) are demonstrated, offering an inherently unshaming approach, grounded in trust in embodied experience and relational support (Kepner, 1987; Frank, 2023).An invented/composite clinical example illustrates how a disowned, shame-bound part of the self can be reclaimed through embodied exploration and relational recognition. This example demonstrates how therapists might work to transform collapse and withdrawal from moral failure into intelligible responses to conditions of insufficient support. The encounter between therapist and client is understood as co-created, shaped by the field conditions as much as by individual history. The paper reclaims psychotherapy as a relational, ethical, and socially-situated practice and as resistance to "psychotherapy without therapy" (the reduction of the therapeutic encounter to regulation and symptom management).
Helen Moss is a Gestalt psychotherapist working in private practice in northern England. They hold a Postgraduate Diploma in Relational Gestalt Psychotherapy and are an accredited member of the UK Council for Psychotherapy (UKCP). Their therapeutic interests include spirituality, neurodivergence, gender and sexuality, and the relational dimensions of psychotherapeutic practice. They are committed to creating spaces for dialogue around contemporary issues in psychotherapy.
Chris Oakley – Response 2
Chris Oakley is a member of the Site for Contemporary Psychoanalysis. He works in private practice and has written extensively about a multiplicity of psychoanalytic themes. His book "Football Delirium", a psychoanalytic account of what we may be using Football to do for us, was shortlisted for the Football Book of the Year.
Timo Sampolahti & Katja Kurri - Psychotherapy research and its discontents – navigating in the riptide of practice, politics and values
The discourse surrounding psychotherapy research is shaped by ideological, political, and epistemological forces that are rarely made explicit. In this paper we examine these forces by situating psychotherapy research within its historical and ideological contexts. We argue that trends such as neoliberalism and New Public Management, which have been reshaping healthcare systems since the 1990’s, have introduced invisible currents into psychotherapy research. To illustrate this argument, we analyze three methodologically diverse articles from the 2024 issue of Psychotherapy Research. We claim that despite genuine methodological advances, the dominant research paradigm in these articles continues to marginalize both qualitative and interactional approaches and views stemming from historical and philosophical research. Furthermore, by doing so, the dominant paradigm does not merely reflect but actively produces a particular image of the human being — one defined by measurable deficits and treatable disorders, rather than by the capacity for meaning, relationship, and self-authorship that psychotherapy at its best seeks to restore. We conclude that promoting methodological diversity, fostering philosophical reflexivity, and recognizing the ethical dimensions of psychotherapy research are essential safeguards against ideologically driven narrowing of the field.
Timo Sampolahti and Katja Kurri are psychotherapists in private practice in Helsinki (integrative individual psychotherapy, couple and family psychotherapy), psychotherapy trainers, and visiting scholars in the University of Jyväskylä.
James Sedgwick - Disorders of Possibility: Describing a contemporary form of distress.
Our current Western milieu has created the preconditions for new types of suffering, including disorders of possibility. The article suggests that these difficulties can emerge in atypically capable individuals where beneficial attributes open up problematic gaps between who they currently are and who they believe they can become. Calling into question a tendency to rely upon marketisation and individualism as the means of accounting for our social malaise, an account is offered which links disorders of possibility to the intersection of meritocracy, social liberalism, democratic decline and economic uncertainty. The three key features of disorders of possibility are identified as vulnerability to shame, the instrumentalisation of the self and the reliance of life planning on a problematically restricted notion of freedom. The article concludes with a suggestion that, alongside political change, the recovery of a lost conception of freedom and a good life may be necessary.
James M. Sedgwick is a UKCP-registered psychotherapist, BABCP accredited CBT therapist and Senior Lecturer in Counselling and Psychotherapy at Birmingham Newman University, Birmingham UK. He is the author of Contextual Transactional Analysis: the inseparability of self and world (2021). He lives in Birmingham, UK.
Keith Tudor – Response 1
Keith Tudor is a Professor of Psychotherapy at Auckland University of Technology (AUT) in Aotearoa New Zealand. He has previously served as Head of the School of Public Health & Psychosocial Studies at AUT. With a career spanning over four decades across the UK and New Zealand, he is a leading figure in humanistic psychology, transactional analysis, and person-centered psychotherapy
Paul Wadey - The Bricoleur in the Consulting Room: Improvisation, Uncertainty, and the Ethos of Therapeutic Presence
'Psychotherapy without therapy' arrives, this paper argues, not when the manual enters the field but when the manual claims it. The provocation indicts not manualization itself but the monoculture under which it operates as the field's only legitimate paradigm. Against that monoculture the paper sets a calibration framing: Engineer and Bricoleur as bounded paradigmatic positions, each accountable to the other in the joint clinical task of discernment. The diagnosis is psychoanalytic before it is political. Scientism, ostensibly the field's defence of evidence, may also serve as the field's defence against evidence, since the alliance literature credits the relational conditions a manualized monoculture forecloses. The bricoleur emerges not as the Engineer's methodological alternative but as the ontological structure within which any clinical work, manualized or otherwise, becomes intelligible. What this asks of the clinician are familiar disciplines: Negative Capability after Bion and Keats, safe uncertainty after Mason, and a witnessing (Winnicott, Buber) the protocol cannot perform. The bricoleur is not what she has but what she is constituted by. The clinic that knows this calibrates; the clinic that does not, engineers.
Paul Wadey is an accredited member of the British Association for Counselling and Psychotherapy (MBACP Accred.) and has worked for over twenty-five years as a counsellor/psychotherapist, systemic family and couple's practitioner, and since 2015, as clinical supervisor, latterly in private practice. He holds a Master of Research in Psychoanalytic History from Goldsmiths, University of London, and a Master of Science in Psychology from the University of Essex. He is the author of Rhythms That Are Wrong (2025) and On Not Finding Yourself (manuscript in submission). His research interests lie at the intersection of European phenomenology and relational psychoanalysis.
