What is ethical psychology?
Ethics is a central theme in the field of psychology. The point of this page is not to summarise the obvious ethical issues such as confidentiality, trust etc, that can be found in any counselling text book. This page is about the challenge to mainstream psychology with regard to the stance and epistemology of the therapist and the therapeutic relationship.
Put simply: do psychologist and psychiatrists have access to a superior truth which is at their disposal for the application to/onto their clients?
Many psychology schools and the training institutions that promote this ethos of diagnosis and defined cure continue to promote a lack of awareness of the connected nature between the client and the therapist. The therapist while seemingly independent of the client cannot be independent. Ecosystemically, the therapist too is part of the therapy including all his/her beliefs and values. His/her background, life experience, likes and dislikes, these are all present in the therapy session. Therapeutic books written too mirror the background, beliefs and values of the author. There is no escaping one’s epistemological stance. Thus, as one enters a room or writes a paragraph, the historical narration of the speaker/author is presented whether he is aware of it or not. The question arises, to what degree does our epistemology affect our knowledge and actions? My answer is that it completely dominates any thoughts and actions that the person performs. This is because it is the learned experiences that one has acquired over their life that shape behaviour. Behaviour is a product of past experience, perception and thinking. The very things we are aware of too are a function of what we have learned before (see the essay “I can only see what I can see” in the essay page). Thus, any statement, action or thought is a glimpse into the life of the very person presenting the action. The statements made by the therapist is a reflection of their own existence. This in turn means that from a therapeutic context the therapist is totally exposed while in a conversation with his client. The therapist and client share the therapy environment and are thus equals in this environment with no superiority required. The same is true for the client system.
The following academic essay was written to provide more information on the topic of systemic therapy and the second-order cybernetic challenge.
First and Second Order Cybernetics. (pdf version) (Webpage version)
The therapeutic relationship has a context and this context is part of the therapy. The culture, language, unsaid rules are all present during therapy. People are immersed in their ecology. They are products of their society. An ecological study of the problem could be incorporated within the therapeutic process. A “one size fits all” method would be ecologically incorrect. Applying a set of learned responses to a client would too negate the client of their unique background.
Labels and diagnosis
The type of labels and diagnosis reflect a certain belief system. While in one culture a person experiencing strange thoughts and invasive dreams with the belief that their ancestors are communicating with them, could easily be diagnosed as delusional or even schizophrenic if the behaviour were persistent. This illustrates the different cultural definitions of odd and eccentric behaviour. The recommended therapeutic solutions for this case would differ between cultures. Labels and diagnosis have their place especially in societies whereby medical aids and government hospitals will only acknowledge such people for treatment if they have been diagnosed. The problem is that labels seek to conceptualise a behaviour from a specific viewpoint and cannot hold true across cultures and contexts. The focus on labelling as part of the therapy is problematic for many reasons. (Please see the essay “Label Killer”). A cultural awareness is important including an awareness that the label provider (therapist) is also the person who sees the label. Whether or not the client needs to be categorised and labelled is a different issue. If the client is looking for a label then that is in keeping with what the client wants but this has a reverse effect. If the use of labels and diagnosis is important in the solving of the clients problems then these labels need to be considered. The use of labels and diagnosis has a reverse edge however. If the therapist relies on labels and diagnosis to explain behaviour, the client too may do this, which leaves a situation whereby more people are “sick” or more people are not responsible for their life owing to the label which they have got or have been given by the therapist/doctor.
A Return to the Home
From an ecosystemic standpoint, the context is critical to the understanding of the information presented or observed. For example, a traffic light represents a means of traffic control and management but only makes sense if it is placed on the roads where it is to function. If the same traffic light is placed in a desert where there are no vehicles or pedestrians, its becomes absurd. It is the context that helps define the content. The same is true in therapy, the client should be seen in their own environment. A leading developmental psychologist named Erik Erickson believed that it was important to view the child in their own environment when conducting his therapy (Erikson, 1963). He would visit the home of the family and have dinner with them. Nowadays this may seem quite strange but surely the home environment is an important part of understanding the family and its members. A psychologist who promotes house-calls? I believe this to be a key feature of gaining a contextual awareness of the client system. Thus, this would be a good way to further enhance the therapist’s ability to step into the world of the client and would be an ethical requirement. The same is true for other environments. A couple who work together and are not getting along and seek a psychologist to assist should welcome the psychologist to the very place where they are experiencing the conflict. The context is not merely a location, it holds clues and provides the observer with the unsaid tacit clues which provide for a larger view of the subject at hand. When people come to me for advise or therapy I need as much information as possible. Hearing the problem is merely audio and body language. I need to see where this problem lives, which means what, where and how. How is this problem continuing. Thus, I promote a contextual first-hand view of the context. While I can never fully experience the same thing as my clients, I can reduce the amount of blind projecting by attempting to match my observations as close as possible to that of my clients. This I believe attempts to close the error gap.
Erikson, E.H. (1963). Childhood and society. (2nd ed). New York: Norton.
The Therapeutic Relationship
Some topical questions:
Where is reality?
Does what we see become our reality?
Should classical psychology be redefined?
What is therapy from a second-order cybernetic view?
The diagnosing therapist: Object diagnosed: Could this be how the client feels during therapy?
Is there another way to the diagnosing therapist?
How do we create an atmosphere of respect and honesty?
Does the therapist have the perfect answers?
What are the core ingredients to therapy?
Can the counsellor/therapist make the relationship?
How different are we from the client?
What is a therapeutic conversation?
What is “conversational questioning”?
What is a “not-knowing” stance?
How do we make the expert disappear?
What is the role of the therapist?
What assumptions does the therapist have?
Do judgements have a place in therapy?
What is a problem?
Where does the problem live?
Why do people’s problems stay with some people, while other problems dissolve?
What factors facilitate change to occur for the client?
Can we call on other experiences of the client in therapy?
Can we create a new history?
Can we create a future?
What is “Local Meaning and Local Dialogue”?
What determines the behaviour of an individual?
What do therapist’s narratives tell us?
What other Associative Forms can be used in therapy?
What Therapeutic Questions are not?
Why should we not try to control our social environment?
What makes up communication?