Book written by Peter Afford,

Not just for Therapy

Review by Gunnel Minett

This book has a slightly misleading title, as it describes itself as a guide for counsellors and therapists. Not to say that it isn’t a guide for people who do psychotherapy, but it’s also a book that has a lot to offer the general reader interested in understanding the human mind.

Psychology and psychotherapy have come a long way from Freud. It has been a bit of a journey, through Jung and later Behaviourism, via bible-sized ‘manuals’ listing a wide range of ‘syndromes’ and ‘disorders’ and their cures (mainly designed to comply with the American medical insurance system) to a wider understanding of how the psyche actually works. An understanding that now also includes guidance as to how to experience health and harmony. 

There is, however, a lot of stigma and confusion around notions of psychological ill health. A common attitude is that psychological ill health is equivalent to catching a cold or breaking a leg, suggesting that psychological ill health strikes randomly or arises from some inherited malfunction  with no links to a person’s environment or background. Assumptions that lead to the conclusion that there is something ‘wrong’ with the person. Alternatively, there’s still a tradition of seeing psychological difficulties as due to some shameful inner failing. One consequence of these attitudes is that both by doctors and patients see psychological ill health as best healed by medication and or some other quick fix. And that the ‘cure’ can only be provided by a (medical) expert who knows how to provide this quick remedy, with the patient as a passive receiver.

This is why this book is such a welcome contribution. It does a brilliant job of clarifying the human psyche from the perspective of someone who knows both about psychological ill health and why psychological ill health occurs. Someone who also has spent twenty years studying cutting-edge neuroscience. Although the book is written in plain and comprehensible language, even for a novice, it is based on cutting-edge neuro-scientific research. It draws on theories from such eminent and well known experts as Antonio Damasio (neuroscience), Jaak Panksepp (psychobiology), Louis Cozolino, (psychology) Alan Schore (neuropsychology), Dan Siegel (psychiatry), Sue Gerhardt (psychoanalysis), Ian McGilchrist (psychiatry) well as Carl Jung (analytical psychology). Together the theories presented in the book offer a comprehensive overview of modern neuropsychological research.  

Neuroscience is another field that has come a long way. In 2000 Bill Clinton and Tony Blair proudly announced the completion of the Human Genome Project and declared that we now had all the answers to understanding human behaviour. And since then there have been many further bold announcements regarding specific genes for all sorts of behaviour, down to shoplifting or to finding a suitable life partner. Some of these scientists have even been smart enough to identify their entrepreneurial gene and turned their findings into money-making enterprises and developed gene-based dating apps (a Tinder for genes) which matches people with suitable genes for a happy future together. Unfortunately the do not seem to have identified the ‘genes’ for status, culture and money, that tend to override any gene suitability and lead to break-ups regardless of how well matched the genes are. Or, as Afford explains, genes are potentials. To understand how and why they are expressed in a certain way, and what it means to the individual, requires a far deeper understanding of neuroscience. 

The more science reveals about the human body and psyche, the more we come to see that psychological wellbeing has multiple causes. There’s a whole variety of functions and processes that are at play. Some are genetic and others come from influences from the environment (epigenetic). To understand these processes we need to learn to distinguishing between the different parts of the brain. There are up-down and left-right influences that play a role. Specific parts of the brain perform certain tasks, and also in cooperation with other brain areas they produce different results. Imbalances in these delicate processes can be, and often are, the cause of psychological ill health. 

As the book clarifies, looking at relationships, social engagement, stress, anxiety, depression and trauma from a psychotherapist’s perspective is only half the picture. By understanding the underlying biological processes we get a much clearer and more nuanced picture of psychological ill health. In particular since so much of psychological healing is about understanding what is happening to us and why: as Afford points out, there are obvious benefits in explaining to his clients how the brain works. It has benefits both as an outlook which avoids the stigma of feeling there’s something ‘wrong’ with me, and as a way to avoid repeating the negative pattern in the future.

For those working as psychotherapists the book offers an essential and very valuable insight into the human body/mind, which was probably absent from their training. For all others, simply interested in understand themselves better, the book is equally fascinating, not to say essential  reading. 

As Afford points out, many of his clients’ psychological problems developed in early childhood. Their parents weren’t able to give the child the emotional support needed to learn good affect regulation. Generally this is because the parent never received sufficient support to develop their own affect regulation. This can be a long and negative chain of events that runs for generations. Not because of some evil side to the human psyche but because of ignorance. As parents we are taught by our parents how to bring up children. We apply the same strategy as our parents used with us. This is particularly the case during our first years. The period before we have explicit memories. This period plays a very significant role. Most parents are not even aware that they are applying a learnt behaviour. Not even those who seek help for their psychological ill health and complain bitterly about their own childhood experiences. And a rather unfortunate aspect of books on psychology is that they tend to deal with how things go wrong. But, as Afford points out, we need to know more about how to get things to go right. 

Despite our growing understanding of the human psyche we don’t seem to apply this knowledge. On the contrary there are alarming reports of growing psychological ill health among younger generations. It is not just the ‘ill health’ of our global environment that we leave to the younger generations to deal with. They also need to learn to live in a multicultural environment and cope with all of the problems that this may bring (something with which we are obviously struggling around the world today). Not to mention the growing population and the harsher competition that this brings to all areas of life. 

So just as Greta Thunberg is leading the way for bringing awareness to the climate crisis, we need a similar campaign to raise awareness of what it takes to replace psychological ill health with harmony and wellbeing. In terms of keeping our planet together, this is becoming as much of a crisis as the climate threat. Even if it may eventually mean a loss of clients, my hope is to encourage the author to write a follow-up book, focusing how to spread this important knowledge to, above all, parents and anyone who works with children, but also to decision-makers and people with influence in society. If there’s going to be any hope of a better future, we simply need to learn what children need to get a good start in life. To actively work for prevention rather than cure. And who better to do this than someone who knows about psychological healing and has spent 20 years studying neuroscience.

Routledge,, 2020, ISBN 978-1-138-67935-1