Psycholoog en de niet zo onschuldige amputatie
van diens autonomie
De
overheid (of wie weet welke usurperende groep?) neemt steeds meer controle op
het nu welomschreven en beschermde – oh ironie – beroep psycholoog. Altoos verengt
de definitie psycholoog in wat mag en wat niet; en ondertussen hield de
psychotherapie min of meer op met te bestaan want daarvoor vindt men alsnog geen
welomschreven wetten.
Een minister
van volksgezondheid opperde dat de psychoog zou terugbetaald worden – niet de
therapeut. Logos, weet je wel, betekent ‘het kennen’ en ‘de gesystematiseerde
kennis’. Therapie of therapeúo (θεραπεύω) wil zoveel zeggen als ‘het zorgen
dragen voor’. Dat is een wereld van verschil, een heel ander discours.
Onlangs
verdween ook de ‘autonomie’ van de psycholoog uit de wet. Zo komen we steeds
dichter bij de para-medicus-psycholoog die slechts op voorschrift van een arts
handelen kan. Goed, het geldt voorlopig nog voor diegenen die een beetje
terugbetaling wensen. Want nu reeds vallen zij die van goedkope tarieven kunnen
genieten, in welomschreven categorieën ingeschaald door een arts met een eenvoudige
vragenlijst: symptomen opgelijst tot een nette quasi medische diagnose. De
kanker op kamer 4, de burn-out van 14u30?
Dat
de psychologie nooit in een (één) ‘wetenschap’ te vatten valt en dat diens
praktijk met de mensen een-voor-een zich nauwelijks in regels laat gieten,
lijkt vele wetgevers nog niet opgevallen – of juist wel en voelen ze dat het de
goede orde verstoort.
Het
is net de beweeglijkheid van het studiegebied en de veelzijdigheid ervan dat om
bescherming vraagt: autonomie. Doorgaans behoedt een vakgebied zichzelf voor
‘charlatans’ en leidt het zelf de psychologen (en/of psychotherapeuten) tot
goede bekwame vakmensen op. Altijd bezig met de mensen in hun singuliere zijn, hun
verwarrend genot of wringende pijn.
Altijd dat bricoleren aan en met de theorieën; de best mogelijke praxis distilleren
voor het met de tijd veranderlijke publiek.
Het
lijkt erop dat die beweeglijkheid/veelzijdigheid nu geordend moet en in strakke
banen geleid: zorgpaden als enige waarheid voor een subject? Of, knecht men het
werk van die weerbarstige psy-wetenschappen en tegelijk het meest intieme en
ongrijpbare van het menszijn? Het argument charlatan of ‘niet-wetenschappelijk’
blijft een stok waarmee men iedereen kan slaan. Definieer ‘wetenschappelijk’
naar eigen goeddunken en bewijs zo dat het enige-ware-zorgpad werkt en al de
rest is kwak. Bestuurders wensen wetten zonder praktische bezwaren.
De
psyche, helaas, blijft ongrijpbaar en stuurt altijd het leven en goed (budgettair)
bestuur in de war. In wat voor vorm een staat de burger ook kneedt, geen mens
wordt automaat, geen staat Utopia.
Nu haalt
men langzaam de psyche uit de wetgeving door deze zo medisch-wetenschappelijk
(lees ook: kosten-baten) mogelijk te formuleren. Zo blijft er enkel nog de nous
(de geest, het intellect, het mentale) waarin iedereen verantwoordelijkheid
heeft over zichzelf: de maakbare voor zichzelf verantwoordelijke burger. Dat
lijkt handig maar is niet meer dan de utilitaire utopie waar alles netjes
geordend in positieve gezondheidswebben tot geluk zou moeten leiden?
Dus onlangs
schrapte de wetgever de autonomie van het beroep psycholoog. Handig want dat
sloot meteen alle psychotherapeuten uit die tot voorheen netjes nog onder het
waakzame oog van de psycholoog zouden mogen werken. Dag collegae
psychotherapeuten die geen psycholoog, orthopedagoog of arts zijn. Vele van hen
hebben goede en gedegen opleidingen en bakken ervaring maar nu staan ze weer
aan de deur van het zogezegde professionalisme. De psychologen beschermen
zichzelf en snijden meteen in eigen vlees – overlangs een slagader.
Auto-nomie
schrappen is meer dan charlatans weren. Autonomie
schrappen, is stellen (niet ongewild) dat enkel door de staat gecontroleerde beoefenaars
van de nous-ologie mogen handelen (kosten-baten liefst voor zelfgestuurde
burgers in het arbeidscircuit). De eerstelijnspsycholoog handelt nu reeds op
voorschrift. En wenst die meer consultaties voor zijn klant dan moet die het
werk en het intieme van zijn klant laten valideren door een adviserend
psychiater. Controle? Check! Goed bestuur voor de grootste gemene deler?
Had
men maar de autonomie bij de diverse scholen gelaten dan was er diversiteit en
keuze. Maar er klinkt steeds weer: “Het kan niet anders!” Hoezo, voorheen liep
het best goed? En diegenen die echt terugbetaling kunnen gebruiken, krijgen het
in het nieuwe systeem toch weeral niets. Charlatans! Wie?
Waar
gaan we nu naar toe? Verbannen we binnenkort de scholen tot universitaire
wetenschappelijke laboratoria en labelen we diegene die niet meestappen tot
charlatans? Laat ons voorzichtig zijn met dat schrappen en het uniformeren van
de psychische zorg.
Ten
slotte zijn die scholen niet alleen de bewakers van de professie en de kuur maar
ook uitvinders van de psychologie en de psychotherapie van de toekomst. Ze zijn
niet, dames en heren van de wet, collegae, de hoeders van het burgerschap.
Autonomie
– oh ironie?
Dit
soort wetten van de goede orde lijken de psychologie te verwarren met de psychotherapie.
Zorg wordt weten hoe gelukkig-zijn moet. (En terloops verknecht men het vak –
voor een vuistvol dollars, aan een systeem.)
Zou
de psychotherapie (psychologie?) nu net niet de beweeglijkheid of autonomie moeten
teruggeven aan diegenen die vastliepen i.p.v. diegenen die beweeglijk zijn,
terug vast te zetten, heteronoom (in een dubieus geluk van een job bijvoorbeeld)?
Een beetje zorg kan
toch geen kwaad ook voor ons eigen vakgebied. Autonomie is altijd een klein
beetje rebellie, collegae, of zetten we daar ook alles vast?
“Four legs good, two legs bad! Four legs good,
two legs bad!”
geciteerd uit Animal Farm van George Orwell.
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