by: Mark McKinley, Psy.D.


The concept of agency is a thorny issue in the practice and research of psychotherapy. An uneasy tension exists between a desire to uphold the traditional values associated with agency, including choice, meaning, and responsibility, while simultaneously privileging scientific methodologies consistent with a deterministic paradigm. In clinical situations, we often borrow from both positions despite the incompatibility of these views.

Agency is typically understood as a capacity to act freely or outside a chain of causality. This capacity suggests that human behavior is not the necessary outcome of a determined cause. An individual is therefore able to act in a multitude of ways, rendering one's particular action meaningful because it could have been otherwise. The ability to choose one's actions preserves our commonsense understandings of responsibility and morality. In contrast, determinism presupposes the natural world (including human behavior) is ordered by causal relationships. Reducing behavior to its causes, however, nullifies the meaningfulness of one's actions because one could not have acted any other way. For example, the output of a computer is not construed as meaningful because it is determined by its programming.

A concerning trend is underway in the field of psychology in which the only valid knowledge claims are derived from methodologies rooted in a deterministic framework. The practice of psychoanalytically-oriented therapy is not immune to this trend. The more we embrace a scientific mindset - one that carries with it the search for causal relationships - the more we bring a deterministic view to bear on our patients. This manner of thinking is evident in our clinical work when we quest after historical or traumatic origins to our patients' current distresses. By searching for a root cause, we obscure the idiosyncratic meanings associated with how our patients have responded to certain life events.

The real danger of a deterministic framework is that it objectifies the human being, imagining the individual as a machine-like system of gears. The allure of this viewpoint is its perceived sense of control, predictability, and certainty. The cost is that it robs the patient of the ability to take responsibility for his or her own life because it presupposes the individual could not act otherwise. This is most disturbingly clear in the movement to identify evidence-supported treatments that ostensibly argue you can make a horse drink. Without being thoughtful about the issue of agency, we can fall into conducting a type of therapy that Martin Heidegger argues cannot result in a healthier human being, but only a more polished object.