The Application of Rawlsian Concepts to Psychotherapy

(Presented at Fordham University; invited to present by Harvard Medical School, 1996)

Published on Academia.edu.

Published in the Journal of Moral Philosophy

Abstract:

A goal of psychotherapy is to affirm and stimulate the development of the person as a free and equal moral individual. Rawlsian theory can be used in therapeutic settings to clarify and stimulate moral reasoning. Central issues that are addressed are the moral primacy of self-respect and self-esteem; distinctions between moral shame, regret and guilt; distinctions between the good and the right, self-command, independence, self-authenticating source of moral claims, and taking responsibility for ends.

Based on the work of political theorist John Rawls, of Harvard, is known primarily for his views on distributive justice, or, how do we live in a society live within a social contract as represented by Locke, Rousseau, and Kant. Rawls presents a systematic account of justice that might be applied in the field of psychotherapy. This is an attempt to present a principle-dependent conception, used as a guiding framework designed to focus moral sensibilities and bring conflicting convictions more in line for the individual, couple or family seeking therapy.

There are two general principles: the principle of responsibility to self and the duty or principle of mutual respect.

1. The principle of responsibility to self.

Free and equal implies a non-victim mentality and forbids self-righteous, mutual overly-simplified moralities. The principle of responsibility to self resembles a principle of right: the claims of the self at different times are to be so adjusted that the self at each time can affirm her rational plan of life that has been and is being followed. The individual should live in such a way so as to not blame her/himself later should the least happy possibilities be realized. One should strive to be free of such regrets as much as possible.

1. The duty or principle of mutual respect.

Mutual respect is shown in several ways: in our willingness to see the situation of others from their point of view, from their conception of the good, and in our being prepared to give reasons for our actions whenever the interests of others are materially effected.

These two principles correspond to the two aspects of a moral personality. To respect another as a moral person is to try to understand aims or interests from another’s point of view and to present considerations that enable another to accept the constraints on their conduct (A Theory of Justice, p. 338).

1. A goal of psychotherapy is to affirm the person as a free and equal person, and to treat others as free and equal persons.  One implication is that two prominent types of deceit are thereby prohibited:  1.) lies of opportunism, i.e., self-serving lies, and 2.) lies of paternalism—lies that protect others from harsh truths.  Within the psychotherapeutic process, stresses can produce a transformation to the attainment of higher levels or greater development.  Often a client is moving from one moral stage to another, without knowledge that this is occurring.  According to Rawls (and subsequently, Kohlberg) it appears that individuals reside at particular levels of moral development, and then move “up” or not, depending on life experiences, education, or interventions.  Ideally, an optimal match between client and therapist would serve the client best.  Research has shown (Kohlberg, Loevinger, Ladenburg) that continued exposure to higher level reasoning eventually causes more complete and developed sentiments which are incorporated into individuals’ reasoning structure, advancing their capacity for logical structured thought and a happier life.  Significant emotional problems result from moral dilemmas from which the client may have no basis for decision-making.  We can assist in decision-making that will benefit the client as well as show respect for others. 
2. Affirmation of self-respect and self-esteem is the single most important primary good.   A goal of psychotherapy is to give the person back his or her sense of being a free and equal person.  An individual often comes to therapy lacking the primary good of self-respect.  Adhering to principles (those that the client defines based on the above two general principles) is evidence of a conscious, active self-command.  The morality of self-command requires treating oneself as someone deserving of respect.

The client needs 1.) a rational plan of life, in particular one that satisfies the Aristotelian Principle (to be explained), and 2.) to be appreciated and confirmed by others. The individual is often isolated. The injury to their self-respect is painful, since it is the loss of a prized good. This is a moral (relating to issues of right and wrong and to how individuals should behave; conscience; regarding what is known to be right or just) feeling and its importance in the work with the client cannot be overemphasized. This is done without judgment of the client, but in assisting him/her to find their own answer that is congruent with who they are. A relationship that affirms self-respect and self-esteem is good. One that reduces the self-respect and self-esteem is objectively bad.

The Aristotelian Principle is a concept that embodies the notion that human beings enjoy the exercise of their realized capacities. This enjoyment increases the more the capacity is realized, or the greater its complexity. The intuitive idea here is that human beings take more pleasure in doing something as they become more proficient at it, and of two activities they do equally well, they prefer the one calling on a larger repertoire of more intricate and subtle discriminations. One is apt to move on to chess once one has mastered checkers. Perhaps a client needs to explore how she is fulfilling her capacities to have a richer, more satisfying life and that is her reason for coming to therapy.

Simpler activities exclude the possibility of individual style and personal expression that complex activities permit, or even require. These features are well illustrated by chess, even to the point where grand masters have their characteristic style of play.

The Aristotelian Principle is a principle of motivation. It accounts for many of our major desires, and explains why we prefer to do some things and not others by constantly exerting an influence over the flow of our activity. Moreover, it expresses a psychological law governing changes in the pattern of our desires. Thus the principle implies that as a person’s capacities increase over time, the simpler things she/he enjoyed before are no longer sufficiently interesting or attractive. This principle might be applied to relationships, which have gone stale by encouraging partners to dig deeper into the complexities of their significant other.

A rational plan of life, constrained as always by the principles of right (duties to others), allows a person to flourish, so far as circumstances permit, and so to exercise her realized abilities as much as she can. Her fellow associates are likely to support these activities as promoting the common interest and also to take pleasure in them as displays of human excellence as well. To the degree then that the esteem and admiration of others is desired, the activities favored by the Aristotelian Principle are good for others as well. (Even if we’re not proficient in something ourselves, we are moved when seeing a great performance whether it be in golf, a film, or politics. We are affected by another’s realization of their capacities.)

The question is: granted that this principle characterizes human nature as we know it, to what extent is it to be encouraged and supported, and how is it to be reckoned with in framing rational plans of life? The role of the Aristotelian Principle in the theory of the good is that it states a deep psychological fact, which accounts for our considered judgments of value. The principle is part of the background that regulates these judgments.

1. The principle of fairness for individuals.

In addition to the subject of social justice, Rawls also defines principles for problems of interpersonal justice. He states that an individual acts autonomously in resolving interpersonal justice dilemmas when he acts from the following principle:

A person is required to do his or her part when two conditions are met: First, the relationship is just or fair, that is, it satisfies the two principles of justice (that of responsibility to self and the duty of mutual respect.) And second, one voluntarily accepts the benefits of the arrangement or takes advantage of the opportunities it offers to further one’s interests. The main idea is that two persons engage in a mutually cooperative venture according to rules and thus restrict their liberties in ways to yield advantages for all. We are not to gain from the cooperative labor of others without doing our fair share.

In relationship, to love another means not only to be concerned for the partner’s wants and needs, but also to affirm her/his sense of worth in her/his own person. The wife’s development is not permitted to take place if this sensibility is absent on the part of the husband. The normal processes of love and affection cannot take place in loveless relationships maintained by coercive threats and reprisals. This concept could be utilized in family therapeutic situations, especially when the husband/father has a tyrannical nature.

2. Promote the achievement of reflective equilibrium.

Reflective equilibrium occurs when our principles and judgments coincide; it is reflective since we know to what principles our judgments conform. It puts order to our thoughts and impulses. Say a client consistently acts-out based on impulses and drives she does not understand. The moral sensibility she might adopt is one in which she “takes care of herself” through making judgments in accordance with a set of principles. A therapist might help her define these principles. She might be educated in regard to discarding those judgments made impulsively or in which she has little confidence. She would be shown that she has the ability, the opportunity, and the desire to reach correct decisions regarding her present life and her future.

1. Persons are self-authenticating sources of valid claims.  That is, they regard themselves as being entitled to make claims for themselves so as to advance their conceptions of the good (provided these conceptions fall within the range permitted by the public conception of justice.)  These claims are regarded as having weight of their own apart from being derived from duties and obligations.

Our own actions can later cause great suffering in terms of shame (defined as the feeling that someone has when she/he experiences an injury to his/her self-respect or suffers a blow to his/her self-esteem. Shame is painful since it is the loss of a prized good. It comes from feeling the diminishment of self, undermining our self-esteem). Guilt is defined as acting contrary to our sense of right and justice, transgressing the rights of others.

If we are required to support and comply with our natural duties, we help ourselves in the long run…

We acquire an aversion to doing what is wrong. A client is often marked by conflict and stress. Correctly defining what she is experiencing (i.e., the difference between shame and guilt) helps her understand her internal process. We can then, as therapists, assist in helping the client resolve this internal conflict.

In conclusion, Rawlsian theory postulates that we are happy when our rational plans are going well, our more important aims are being fulfilled, and we are sure that our good fortune will continue. In a practical sense, part of the intervention with a depressive client is to activate a rational plan of life that is meaningful to her.

We believe that Rawlsian concepts contribute to a sense of coherence in daily life, giving one a greater sense of meaning and the ability to view the world as comprehensible, when based on principles. Acting with deliberate rationality (making choices which are directly the result of self-knowledge), a client can see herself as a continuous being over time. She can understand that as long as she is prepared to live with the consequences, she may live a life absent of deep feelings of regret. This can greatly enhance a client’s confidence in her decision-making ability.

Bibliography:

Csikszentmihalyi, Mihaly (1993) The Evolving Self HarperCollins: New York

Erdynast, Al (1994- 95) Antioch University, Los Angeles.

Erikson, Eric (1959) Identity and the Life Cycle Psychological Issues, 2, p. 51-57.

Rawls, John (1971) A Theory of Justice The Belknap Press of Harvard University Press; Cambridge, Mass.

Weiner, P. (Ed.) (1973) Dictionary of the History of Ideas Vol. IV, Scribners & Son: New York.