This was a difficult article to write, partly because of the exceptionally high level of feedback from the rest of the Herbarium team, but mostly because it tried so hard to turn itself into a small book. I’ve confined myself to a single but telling aspect of the dialogue that the times demand. With the apparent mothballing of the Statutory Regulation process, the ongoing demise of the educational system created to serve it, and the meltdown of the herb trade in the wake of the THMPD, herbalists in the UK must pause to consider who and what we are, and where we’re going. Are the ‘professional’ herbalists of the last two centuries about to die out, and should we really mind? What sort of herbalists might replace them, and with what ethos? How would they learn their craft?

Stephen Church

In the early 1990s when I was working for NIMH and exploring what might have been a more inspiring model for professional development than is manifested these days, I spent some time with Crosby Chacksfield, an extraordinarily able educator who, amongst many useful things provided me with these two definitions: –

  • Competence: the ability to function satisfactorily in familiar circumstances.
  • Proficiency: the ability to function satisfactorily in both familiar and unfamiliar circumstances.

Let’s flesh this out a bit. Competence is about applying established solutions to pre-defined problems. Competence can therefore be measured, so it is easy to document, easy to teach, and easy to assess. Competence is based on vertical thinking. Competence is also the territory of risk management, evidence-based processes and centralised control.

Proficiency, by contrast, is about having abilities both more profound and broad-based – acumen, skill, flair, and audacity – to work in unknown territory and still be able to move towards a positive outcome. Lateral thinking is required. Proficiency is hard to measure, teach or assess, although it can be exemplified, recognised, and ultimately approved (or, of course, disapproved when it doesn’t go well). Proficiency used to be the territory of the professional – individuals sufficiently highly educated, conditioned and motivated in their chosen field (teaching, law, medicine, etc) that they could be trusted to act according to the best of their ability with a high degree of autonomy. There was a framework of competencies, of course, but also clearly plenty of headroom for individual talent and experimentation.

In a way, my discussions 20 years ago might seem to have very little relevance now, as proficiency (and professionalism) have been thrust aside in favour of an almost fetish-like demand for competence. Why has this happened? My own guess at the reason is two-fold. It’s partly because we now live in a world where human organisation is based on central control, and you can only control what can be measured and assessed. At the same time, the computer/interweb environment is the modern way to administer these control systems – and computers cope brilliantly with the yes/no environment of competencies, but very poorly with the ‘it depends’ environment of proficiencies.  Which chicken came before which egg is hard to know, but one can easily see how much of the modern world of occupational and social order (or disorder!) is defined by competency-based systems, and how badly it has all gone wrong: it has caused the dumbing down of just about everything, and has contributed to the creation of pyramidal, over-bureaucratised systems that are now creaking under their own weight.  On a more parochial level, one observes that workers in those fields that touch closely on herbal medicine – teachers, midwives, nurses, even doctors themselves, have had their status insidiously eroded by a process of de-professionalisation as proficiency has been sacrificed on the altar of competence. One also notices how much the demand for ever more detailed definition and evidence of competency has been done in the name of safety, and yet this process has manifestly failed to make the world a safer place.

Before bidding a fond farewell to the world of the proficient professionals of yesteryear, one should rightly enquire as to how they were nonetheless governed. Much of the answer lies in another near-redundant concept, ethic. The rule-book of, for instance, professional medical ethics is incredibly slim in terms of concept: you shall always work to the best of your ability for the benefit of your patients (this lies at the heart of the Hippocratic Oath); you shall do no harm; you shall not abuse patients in any manner; you shall avoid negligence; you shall not take life; you shall work for a greater good; you shall behave respectfully to your peers; and (the tricky one!), you shall conduct your private life as ethically as when you are working. Simple enough, though often highly complex in terms of detail and delivery. But if the idea of leading an ethical existence is instilled at professional birth, as it was for myself and all my generation of herbalists, then it becomes second-nature. This is not to say that problems might not arise – in my own experience of herbal medicine minor transgressions were sometimes evidenced – but there was a straightforward process in place of complaint, inquiry, judgment, discipline and compensation that worked well.

So now we jump to the present day of herbal medicine, where we too have been dumbed down as competence crowds out proficiency, and we have effectively lost our professional status. It is particularly telling that the term ‘professional’ is mostly used (and mostly hidden) in the acronym ‘PA’, short for Professional Association. Do these PAs and their executives conduct their affairs in an exemplary, ethical fashion? All too little. The excuse is, that to deal with the macro-environment, particularly the world of politics, it is necessary to work according to the style of the times – which is at no level anything to do with ethic, or if it is, it evidences a new ethic, that life is simply what you can get away with. We live in a world where the end justifies the means, and the objectives are money, power and control.

Does it really matter if herbal practitioners are now trained and conditioned to a (hopefully) high level of competence, backed up by the sort of control systems anticipated in statutory regulation, without the bolt-on extra of proficiency? Surely the fact that it’s different doesn’t necessarily make it better or worse? But manifestly it turns out to be worse – much, much worse. By now, a majority of those who studied herbal medicine were trained and conditioned to work in the current environment of competence and control – effectively a systematic approach prescribed by, and compatible with, ‘the system’ at large. It matters not a jot if I disapprove of the proponents of the process or the objectives of this modern initiative, it’s by now more than apparent that it simply doesn’t work. It’s true that no student course in herbal medicine can achieve more than the equivalent of passing a driving test – only once you get to drive solo do you really start learning. But the BSc courses with their tight focus on competencies give too little foretaste of the need for proficiency in successful practice, and it makes for such an uphill struggle – evidenced by the extraordinarily high rate of failure amongst BSc graduates attempting to enter herbal practice as a job of work. The universities seem to have very little awareness of what fate befalls their graduates, and the PAs they join (however briefly) appear equally complacent.  If this wasn’t bad enough, one also has to consider whether the system mainstream herbal medicine was browbeaten into becoming a part of has much of a future itself – and if we don’t think the failing macro-system will recover (I can neither imagine nor wish that it will), then the whole thing reduces itself to the absurd.

I hope this is not starting to read as simply sour grapes from the old to the young. One of the delights of working on The Herbarium is the contact it has fostered with herbalists of all sorts, and I am able to give personal witness to a gratifying smattering of new practitioners in whom the qualities I associate with proficiency appear to be innate. Many of them did not study at University, some pass completely beneath the radar of officialdom, but they are nonetheless proficient, ethical, courageous and successful herbalists. Perhaps it’s because they learnt more about herbs, or perhaps there was nobody to frighten them off.

Whatever one thinks of the effects of competency-based systems on the macro-environment, or even on orthodox medicine (not much of a role model at the moment!), they are singularly inappropriate to the milieu of herbal medicine. More than any other medical modality, we are concerned with nature – at the heart of our work is the matching of the nature of plants to the nature of humans – and nature, in all its manifestations, is essentially mysterious. Consequently, everything we do involves dealing with unfamiliar circumstances… and requires us to act proficiently. We clearly cannot satisfy ourselves with the evidence-based approach of ‘Echinacea is good for colds’ – nobody needs to pay a practitioner to work this out for them, do they? I often talk about things that raise or lower the ceiling on what can be achieved in herbal practice: more than any other current concern, trying to work (as modern training dictates) in a competence-conditioned environment brings the ceiling so low to the floor one questions what the point ever was in theory, and observes even less point in practice.

I was initially reticent to publish these thoughts as it will upset a great many people who I’m sure are dedicated and working in good faith. But if herbal practice is going to survive and move forwards, perhaps we all need a shock or two. Herbal medicine only works well in the context of vitalism and holism – embracing the imponderables of life, empowering patients to escape from the cycle of treatment and dependence, and helping them (and ourselves) to reconnect with nature. To do this we are required to be inventive, intuitive, inspired, and to dig deep into our personal life experiences and innate capacities for healing. We need to gain in proficiency because every single patient is different, and every single moment of their lives a step on the path of their own personal adventure. Thus every single treatment is an experiment, an unfamiliar set of circumstances that we must respond to as best we can – and when we do this well, miracles can be performed. Beyond proficiency lies mastery – which Paul Bergner discusses in the Herbarium article, ‘How to become a Master Herbalist in thirty years or more’. If I personally have enough of a working life left to achieve this I shall be mightily pleased.

What is manifested by the (all too few) good, successful herbal practitioners, and certainly what will be required of us in the future, is much the same as it has always been – to have the courage, motivation and inspiration to work autonomously, proficiently, professionally, and ethically. My own life course as a herbal practitioner has also been a process of breaking free from the social conditioning of the times I grew up in and live in – to be conformist, fearful of authority, to feel that pleasure must be bought and that self-worth is a function of spending-power, to doubt myself whenever I experience anything for which there is not a perfectly good scientific explanation, and so on. Social conditioning is the poor brother of brainwashing – it can be hard to escape, and a continuous effort to remain free. But it can be done, and if you yearn for a system based on goodness and choose to play your part, it must be done.

So this is an exhortation to all you modern herbal students and graduates. Move beyond the doctrine of limitations of your training and escape from the trap of fear. Go out into your gardens and woodlands and heaths and have the courage to allow the magic of nature to embrace you. Invite people to come and see you, listen to their stories, and let them fill you with wonder. Draw on our rich fund of empirical knowledge, and add your own stories to our legacy of anecdote. Work hard, be brave, be inspired, be intuitive, be clever. Be humble, struggle to make a living, doubt yourself, be frightened, fail when you must, but keep going. Above all, learn from every experience. Become a proficient herbalist.

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