Render unto Caesar…

I sat for a 7 hour Case Based Assessment on Saturday.  This is a mandatory requirement of my licensing College (CRPO).  I was randomly selected.  My first lottery win!  It was a brutal experience.  The 30 cases that comprised the assessment were so nuanced and many of the constructed scenarios unrelated to the type of work I offer.  I do not do family therapy, work in a clinic, or work with children.  The pass required is 80%. I have no sense of whether I was able to rank the 5 responses for each case in alignment with adherence to the College Standards of Practice.  Generally, the one most aligned was somewhat obvious, or at least so I believe, but the outlandish and tricky ones that followed were harder to rank.  And by the 20th case, I was in such a brain fog as mental fatigue eclipsed discernment, I pushed through to just be finished.  We are told it is a low-risk endeavour, designed to instill quality assurance on the profession, but, man oh man, some of the scenarios while ‘designed to protect the public’ were not necessarily designed to protect the therapeutic alliance or the therapy.

I have been a non-elected member of the Council of the College for about 5 years, charged with the task of working on Indigenous Pathways to Registration.  This has been profound and rewarding work.  I was pretty sure I was fluent in the competencies both in my praxis and in my knowledge, but this CBA experience has punched a hole in my confidence.  I guess that is not always a bad thing.  I spent a good part of the weekend doing a forensic reread of the Standards of Practice to try and ease my anxieties and prepare me for either a successful or unsuccessful result.  The standards for practice are thorough and exacting, and the professional development, self-assessment, clinical supervision stipulations are rigorous.  The public is well served. I have always met my responsibilities in this regard.  But this CBA was much like those word problems from grade school.  A train leaves the station travelling 40km/hr and passes a train going in the other direction traveling 67km/hr.  At what time will the 2nd train reach the main station?  Now, imagine 5 answers that require not only the best or correct answer, but that each response be ranked.  My head wanted to explode.  It still does.

I am glad that I have a light schedule today.  I need to re-calibrate my therapeutic attitude and move back to the centre of my brain.  The left brain thinking imposed by the CBA threatens to eclipse the creativity, openness, divergent, and nuanced right brain thinking required of a psychotherapist and particularly of a Jungian analyst.  As a Jungian analyst, I know I will always operate on the right edge of the centre.  Listening to the deep unconscious in myself and in my analysands requires a different set of skills than strictly CBT or DBT therapy requires.  I am not prioritizing one set of skills over the other.  They both have their value.  One cannot do depth psychology without a stable and functioning ego.  However, if egoic approaches were all that was required to address deep suffering or repetitive patterns, we would not have the mental health crisis in the West that we currently experience. 

It is somewhat ironic that I have worked to assist indigenous practioners, both in the Grandfathering Phase when the College was newly passed into law as a ‘controlled act’, but also under the mandate of ‘Truth and Reconciliation’ with indigenous people.  In the IPRC work, we sought to clarify and recommend to the Registrar, a non-traditional pathway to registration for healers and Traditional teachers. I wonder how many of those registrants would fare on the CBA?

I am reminded of a question asked of a Rabi on the dusty pathways of Jerusalem some 2 thousand years ago.  When asked whether to pay taxes to Rome when the teaching he offered spoke of treasures in heaven, the response was “Render unto Caesar the things that are Caesar's, and unto God the things that are God's".  We surely need both secular and spiritual discernment.  We need left and right brain approaches. I pay my taxes, and I meet the mandates of my College and profession, I pay my professional fees and insurance premiums.  I involve myself in constant professional development and read and research extensively.  To the best of my ability, I align my praxis to the requirements of Safe and Effect practice, keeping my competencies current and ever developing.  And yet, more than twenty years of experience in the chair are shaken to the root bed by the CBA experience. 

This blog today feels a bit like confession, a bit like an explanation, hopefully not too much like an excuse, and a bit like preparation.  If I fail the CBA, I will have to spend more time and effort focusing on the important but very secular work of Standards.  There is a balance to be forged between secular understanding and spiritual vocation.  My work as an analyst is a sacred vocation.  Hour after precious hour, people come to me and together we work tirelessly to understand what is calling them toward meaning, healing, and deeper understanding.  I am not a healer; I am a registered psychotherapist.  I am a Jungian analyst.  I am a facilitator, a translator, a guide.  The unconscious steers the vessel.  Some would call this spiritual.  And while it is essential that as a psychotherapist working under the controlled act of psychotherapy in Ontario that I am deemed competent by my College, and the public is protected, sometimes the means to an important end are clumsy.    

Mine is not the only profession regulated by a College in my province of Ontario.  Doctors, surgeons, psychologists, social workers, massage therapists, teachers, osteopaths, nurses, etc. are regulated and controlled professions.  Increasingly, the government intervenes in our lives and puts safety as its highest value.  This may be what keeps our commercial kitchens E.coli free, our Conservation areas sustainable, and our professions professional.  I support these regulators and these regulations.  At the same time, this morning, still bruised from my 7 hour Saturday experience, I ponder the ways and means at which these things are accomplished.