Potential Space

by Mark McKinley, Psy.D., Impulse Staff Writer


One aspect of the practice of psychotherapy that seems vital yet is often overlooked is its moral dimension.  This dimension ostensibly goes unnoticed because of the socio-historical alignment of psychotherapy with science and a desire from its practitioners to present it as a values-neutral enterprise. Despite efforts to maintain such objectivity the practice of psychotherapy seems profoundly influenced by morality and being unaware of this impact can have adverse consequences.  

Morality is defined here to broadly describe the qualitative distinctions made between right and wrong, better or worse, higher or lower ways of conducting one's life.  These discriminations demark value commitments which underpin notions of what constitutes the good and inform considerations of what makes life meaningful.  The moral dimension of psychotherapy therefore refers to the realm of engagement that has to do with the values involved in how patients comport themselves.  Assuming there is no one universal way to carry oneself, any dialogue addressing the manner in which a patient engages or responds to a particular situation invariably rests on moral evaluations.  To the extent that psychotherapy is an exploration and facilitation of how one relates to one's self, others, and the world, it necessarily draws upon moral sources to govern such ways of being.  

The danger of not being cognizant of the moral dimension is to unwittingly perpetuate culturally sanctioned ways of being that may negatively impact non-normative groups.  This is most evident in critiques made from the perspective of multiculturalism.  In not recognizing the underlying value commitments that guide our behavior, we can easily naturalize moral standards to appear as if they were self-evident truths.  The peril of promulgating value-laden ways of being in the language of health or science is that it has a political consequence of oppressing variant forms of human expression.  

By highlighting the moral dimension of psychotherapy, we are able to critically examine and thereby open space with our patients to explore, elaborate, or shift one's moral evaluations to help facilitate new ways of being.  How one carries oneself in the world is not a medical or scientific question but is inherently a moral question.  Since we cannot escape the moral context of our being, it seems best if we aim to become more transparent with our own value commitments and how they shape our practice of psychotherapy.