Ethics

                                                                           Every tool is a weapon, if you hold it right.

 Discourses delimit the world. They point our attention in some directions, inviting us to engage in particular ways, and in doing so, neglect other possibilities. This holds for the bedtime parables we share with a child to ward off nighttime fears, and it also holds for the grand epistemological discourses that inform us as we engage in therapeutic conversations.

The discussion to follow may appear at times to reprise an increasingly familiar theme: that modernist discourses about knowledge have a tendency to put the knowledge of the therapist ahead of the knowledge of the client, and in so doing, obfuscate or even contradict the client’s experience. My intention here is not to develop that worthy theme: the critique of modernist epistemologies as they relate to therapy has been conveyed effectively in countless contexts. Instead, I will briefly revisit that critique as a stopping point en route to a less widely discussed notion—the idea that epistemological discourses that have arisen out of the critique of those modernist epistemologies can also lead to the unilateral imposition of meanings. It is our relationship practices, rather than our philosophical standpoints, that are key in determining our clients’ participation in therapy. A critical epistemological stance bent on emancipation may still oppress, depending on how it is wielded by the practitioner.

 "Knowledge does not belong to one of the terms of the relation, or to both of them separately, but is produced within the relation"
Montero, 2001, p. 86

The nuance of therapeutic relationship is endlessly complex; I cannot hope here to touch on its enormous scope. Instead, that relationship will be considered in terms of knowledges—those brought to the relationship by clients and therapists, those jointly constructed in conversation. Strong (2001) provides a useful conceptual rubric for negotiating these ideas. He speaks of the discourses that therapists bring to their sessions as "my house". These include theoretical concepts and therapeutic models, of course, but "my house" also encompasses the ideas, beliefs, and practices associated with the many "cultures" (Paré, 1995, 1996) of which the therapist is a member. And while one can expect the client has been exposed to and draws from a range of discourses alongside the therapist, each comes to these with unique personal histories that inevitably render unique the manner in which they make meaning in the world (Martin & Sugarman, 2000). The client’s discursive context is therefore distinct, says Strong, who uses the term "your house" for the systems of understanding that inform their meaning making and actions. Strong advocates for a collaborative process that constructs an "our house", which he views as an "an optimal context of mutuality" for collaborative therapeutic work. This meeting place is akin to Gadamer’s notion of a "fusion of horizons" where what Gadamer calls the "traditions" associated with both interpreter and text come together, and the interpretation rendered is the product of the interchange between them (Hekman, 1984).

It might be helpful here to briefly characterize the recent evolution in epistemological discourses as they pertain to therapy. Traditionally, psychotherapy in its many guises—both individual and systemic—has tended to hold clients up against some cross-contextual and predetermined standard of health or functionality. The standard changes significantly from orientation to orientation: it may pertain variously to the management of internal conflict and desire, degree of self-actualization or authenticity, accuracy of cognitive schema, or interactional sequences and structures. While the therapeutic orientations relying on these points of reference represent significant departures from a natural science view bound up in biological description, they do share some epistemological resemblances. They are discourses that rely on universalist points of reference--normative accounts of human functioning. Following Strong (2001), one might say these accounts are located in "my house" and precede the construction of "our house" through therapist/client interaction.

The contextually-informed therapies are not explicitly1 informed by accounts of health or wellness, seeing all accounts as culture-bound constructions of language that may or may not have utility in the situation at hand. These therapies include narrative, solution-focused, collaborative language systems, and feminist post-structural approaches (Anderson, 1997; Davies and Harre, 1990; deShazer, 1991, 1994; Freedman & Combs, 1996; Friedman, 1993, 1995; Hare-Mustin, 1994; Hoyt, 1994, 1996; Madigan & Law, 1998; McNamee & Gergen, 1992; Monk, Winslade, Crocket, & Epston, 1997; Parker, 1999; Weingarten, 1995; White & Epston, 1991; White, 1995, 1997; Zimmerman & Dickerson, 1996). Just as the therapies associated with universalist epistemologies vary widely, so do these approaches differ in their emphases. What they share is an eschewal of normative guideposts. Rather than turning to some conception of health, functioning, or wellness, they pay attention to the dialogic process and seek, if anything, to emancipate persons from universalist specifications.

In referring to these therapies as "contextual", I do not intend to propose the title for a new "school" of therapy. However, I do suggest they share a distinct family resemblance. In Burr’s (1995) broad sense of the term, these various approaches are informed by some variety of social constructionism. They view knowledge and meaning as the product of social interchange, and regard universalist ideals for health and functioning as social constructions that may or may not suit the context at hand. The contextually-informed therapist aims not for "healthy human functioning", but something more akin to the co-construction of preferred realities (Freedman & Combs, 1996). Therapeutic conversations may periodically center on questions of what is "healthy" for example, but the process is more akin to a shared querying of the term as it applies to the client, rather than a therapist’s effort to nudge the client towards a preconceived conception of health.

Normative traditions therefore put the locus of knowledge in "my house", a space piled high with professional and popular conceptions about, for example, "repression", "conditioning", "self-actualization", developmental "stages", "dysfunctional thinking", and so on. Social constructionists argue that these and myriad other psychological constructs are arbitrary. They are outgrowths of discourses that entrap us within "linguistic worlds of our own making" (Shotter, 1993, p. 27) and their purported truth status evaporates as soon as one steps out of the discursive contexts that give rise to them (Gergen, 1994).

This critique of normative traditions is an important one, however my intent here is to highlight the inadequacy of a response that purportedly erases the contribution of the therapist to the therapeutic process. For when we "step out" of one discourse—in this case, a normative one--we step in to another. A story about knowledge that critiques the over-emphasis on decontextualized professional knowing is still a story. And therein lies a challenging, but crucial paradox. When this alternative epistemological story, acute in its articulation of the perils of lionizing universal truth claims and therapist expertise, is not the subject of joint consideration by client and therapist, it still frames both content and process of the work in the "my house" of the therapist. It suggests that therapists relinquish their expert knowing, only to replace it with an (epistemologically informed) expert not-knowing. This does not capture the collaborative orientation favored by the contextual approaches. Instead, we need to commit to knowledge-making as a process of what Shotter (1993) calls joint action. The derivation of an epistemological stance, the quest for an answer to the question "what counts as useful knowledge?" should be a communal effort.

A central feature of this response to expert-centered practices is the elevation of what Geertz (1983) calls "local knowledges"--the context-bound practices and meaning-making inadequately captured (or downright obscured) by theories derived from universalist epistemologies. This turn to the local has been accompanied by an attempt to downplay therapist expertise, characterized by familiarity with ‘the literature’, which abounds with decontextualized knowledge claims. The contextual therapist is construed as "leading from behind" and adopting a "not knowing" stance (Anderson, 1997; Anderson & Goolishian, 1990; Freedman & Combs, 1996; Griffith & Griffith, 1992; Hoffman, 1991). Clients are regarded as experts in their own lives (White and Epston, 1991), and therapists approach the therapeutic relationship with an orientation of beginner's mind (Epston, 1993), curiosity (White, 1997), and misunderstanding (de Shazer, 1991).

Nomothetic knowledge is law-based. It tells us what always was (was immer ist) -- what is recurrent across particular instances (Lamiell, 1995). It is the foundation that much of academic and professional psychology rests upon--the storehouse of facts, methodologies, theories and constructs that psychologists typically draw from in their practice. Nomothetic knowledge is hoarded in "my house"; it is the stuff of professional expertise.

Idiographic knowledge is more akin to local knowledge. The term idiographic means based on the particular individual (Lamiell, 1995). This is the domain of ‘your house", the stuff of client expertise. It includes not merely the detail of a person’s local environment, but their interpretations, their meaning-making, their own peculiar wisdom in taking on the challenges of their life in all its contextual uniqueness2.

There is a certain therapeutic resonance to the distinction between general, dominant understandings and particular, context-specific understandings. It promotes a view of therapy as a dialogue that surfaces alternate knowledges and practices--often through the deconstruction of dominant, normative, cultural ones. To risk overextending the metaphor, it depicts therapeutic change as the emergence of the idiographic from under the oppressive boot of the nomothetic. However, when reified, the distinction instantly falls prey to the "irony of domination and repression inherent in most of our efforts to free one another" (Lather, 1986, p.265).

1. 1. The "privileging of the local" does not depict therapy as dialogic, and risks excluding potentially helpful material from therapeutic conversations

    

After ingesting a rich diet of ideas and practices associated with the contextual therapies, my student colleagues often ask why they should bother pursuing "higher education" in counselling if the expression of any ‘knowing’ by the therapist is an ill-advised imposition, a remnant of oppressive modernist practices? My sometime (lame) response has been to say that the "expertise" they are learning lies in the ability to evoke the client’s expertise, rather than to impose their own. But this depicts the therapist’s role as the mere elevation of local knowledges, and I do not believe it is sufficient.

When the metaphors of " expert client’ and "not-knowing therapist" reduce our work to the mere unearthing of individualistic client "strengths", the description of therapy becomes impoverished, to the detriment of those who consult us. An irony of the stubborn quest for local knowledge to the exclusion of other ideas and practices is that, while it is motivated by respect, it assumes incapacity on the others’ part to engage with those other ideas and practices. Respect should lead to a willingness to join with clients in a critical evaluation of much that lies outside of their current sphere:

1. 2. The critique of natural science epistemologies is often accompanied by the summary dismissal of all "modernist" therapeutic ideas and practices

    

This is the "baby and the bathwater" clause. It makes sense that a growing sensitivity to issues associated with knowledge and power leads to a critique of psychology’s oppressive traditions (Sloan, 1997). But surely it is hubris to claim that virtually a century of theory and practice got it ‘wrong", and should be tossed out, in favor of the new regime.

Meditations on therapy’s hegemonic potential are a welcome addition to the conversation about how to be helpful to persons. However, while these offer an expanded consideration of the ethical dimensions of the work, they are not accounts of the ‘right’ way to do therapy—final answers to our theoretical and practical questions. Those answers must be sought within therapeutic relationships, in concert with those who consult us. "Modernist" therapists can engage clients in a reflexive evaluation of their practices, just as a ‘postmodern’ therapists can relinquish dialogue in the zealous quest to liberate clients from a modernist world.

3. Local knowledge is always informed by wider cultural discourses.

Language is never private (Wittgenstein, 1963), and neither are the meanings negotiated in therapeutic conversations. When we attempt to "privilege a local meaning", we are still making space for a socially-derived meaning because meaning-making is a cultural process. Meanings or knowledges do not inhabit persons; nor do we come to "own" them in the way we may own a bicycle, or a book. The more important question may not be "Whose meaning is this?", but "How does it impact on this person at this place and time?". This question, too, should not be asked "of" someone, but "with" them: jointly interrogating meanings and their impact is what shared knowledge-making is about.

Consider, for example, the case of a therapist working with a young woman who the health professionals say is dying of malnutrition. Persistently, the client insists she is "fat", and "fat is ugly", and her preference is to continue her current eating patterns. A simplistic understanding of the "client as expert" metaphor would lead us to conclude she has spoken from "her voice" and it would be inappropriate to challenge her. But clearly this is problematic. To merely privilege what is gauged to be local, the "voice of the client", may entail passively witnessing a young woman’s sacrifice to the dictates of corporate prescriptions for female beauty3. As Larner (1999a) says, "to not take a position is itself an act of violence, implicitly condoning the injustices suffered by the client" (p. 48).

4. Epistemological stances (including not-knowing ones) are discursive positionings that are invariably informed by a "knowingness" of some kind.

Although the notion of turning up the volume on the client’s voice is not primarily concerned with eradicating the therapist’s, the language of "not-knowing" sometimes has a tendency to suggest as much. In its (refreshing) emphasis on making space for the client’s perspective, some of the literature associated with postmodern therapy seems to advocate that therapists bury their learnings in order not to colonize clients with them. But to adopt a "not-knowing" stance is not to relinquish one’s place in the universe. Rather, it is to advocate for a particular way of positioning oneself (Davies and Harre, 1990) vis a vis the client. In other words, the attempt to privilege client expertise is informed by culturally-situated postmodern critiques: in this sense, it is a "not-knowing knowing" (Larner, 1996, emphasis added).

The "curiosity" which reflects a not-knowing stance expresses itself as questions. But questions about what? Whichever way our curiosity directs us in conversation, it is informed by knowledges--even if it is knowledges about knowledges, such as a familiarity with Foucault’s social critique. "Not-knowing" is inevitably the expression of a knowing informed by and situated in the discursive and material traditions into which we are born. We cannot escape this knowingness, but we can bring ethics to the forefront in our engagement with it. Epistemological discussions (like this one) should not be divorced from consideration of how any particular story about knowledge impacts on those to whom it pertains.

Discursive wisdom is a posture that makes room for both the therapist’s knowing, a knowingness that may extend to psychological practices and discourses, and not-knowing, the acknowledgment of the limits of knowing, the suspension of knowing which calls forth other voices. The alternating between knowing and not-knowing creates the space for the mutual construction of new meanings. In this sense, discursive wisdom promotes what might be called a "knowing-with", because it is committed to dialogue, rather than the monological imposition of meaning. Shotter (1993) uses the term "knowing from" to depict what I take to be a similar emphasis on the ethical commitment to a knowledge borne of relationship:

The most distinguishing feature of discursive wisdom may be its reflexivity: it maintains a perennially critical disposition towards discourses4, including the discourses that inform it. "Critical", as I use the word, does not presuppose negative judgment; instead it speaks of an ongoing evaluation--a skepticism, of which Shotter (1993) writes "we should be not only incredulous towards grand narratives, but also suspicious of all stories, even little ones" (p. 30), because of the impulse towards a systematic order that obscures other features of everyday life and the moment before us.

Discursive wisdom is characterized by an attention to the ways in which discourses operate in our lives: the ways they "systematically form the objects of which they speak" (Foucault, 1972, p. 49), the ways in which they undergird our taken-for-granted practices, the ways in which they open up new paths, but "only at a certain price, only, that is, by bolting shut other passages, by ligaturing, stitching up, or compressing, indeed repressing, at least provisionally, other veins" (Derrida, quoted in Larner, 1999b, p. 9). A reflexive posture leads us to consider which veins our perspective currently mines, and which it excludes, and to make that consideration visible, or "transparent" (Freedman & Combs, 1996; Freeman & Lobovits, 1993; White, 1995) to those who consult us. If competent practice calls for "expertise", reflexivity promotes an inquisitive expertise shared with clients that makes the unfolding dialogue a primary object of investigation. This mutual querying of knowledges positions therapist and client as subjects in a therapeutic conversation.

The word deconstruction is used in a baffling variety of ways. The sense I am trying to capture here is deconstruction as a shared inquiry into the genealogy of meanings, the tracing of words (as Bakhtin (1986) might say) to the mouths of the many others who have spoken them in different contexts, and with purposes that may or may not reflect the purposes at hand. This form of deconstruction presupposes that the meaning of words is a function of the context in which they are being spoken, and have been spoken; language is forever subject to the "contingency and variability of human societies, cultures, and communities" (Dewey, quoted in West, 1989, p.70). Deconstruction attempts to make visible that contingency and variability as it impinges on a therapeutic conversation.

If reflexivity suggests evaluation, deconstruction at least begins to provide us with a method. In this sense, deconstruction can be a tool of reflexivity. Deconstruction furnishes us with rich descriptions of discourses--those we bring to therapy, those we encounter there, those we co-generate with our clients. Like a rich tapestry, a discourse can be understood as woven with threads of what White (1992) calls the "culturally available and appropriate stories about personhood and about relationship... historically constructed and negotiated in communities of persons, and within the context of social structures and institutions" (p 124).

Cultural discourses are always with us: they are reflected back in what Hare-Mustin (1994) calls the "mirrored" consulting room. They are present in the spoken words and the unspoken gestures we produce in our therapeutic conversations. By "discourse" I do not mean to exclude body language: tears or posture, which also speak to meanings that may be jointly traced or explored. A deconstructive orientation prompts us to keep these discourses in view, and to render visible the practices of power that sustain the foregrounding of some accounts relative to others. This includes not only dominant cultural stories we may deem to be "marginalizing", but also our own--our reframes, theories, models and epistemologies--which our hubris tells us are sure to be liberating for the persons who consult us.

It is worth emphasizing that a therapeutic direction informed by pragmatism as it is used here need not be contrasted with, say, "having an intense emotional experience". A pragmatic response is one invited by the particularities of the moment, rather than suggested by an overarching theory. This is the distinction developed at length earlier between some form of disembodied, normative template according to which we gauge the situation-at-hand, versus evaluating these meanings at this time in the present context for their impact on those involved. It stands in contrast with the practice of identifying a client as a member of a class ("A") of persons, and applying an intervention ("B") which is assumed to apply to all "A’s". If a B-like response seems called for, it is because of the unique features of the client’s situation at this time and in this relationship. As Amundson (1996) puts it "if pragmatic emphasis requires anything, it is to question the value of any idea a priori, and to suggest that the contextual circumstance of the individual tells us how to employ, shape, or deliver a given idea" (p. 483). `

"Praxis" therefore implies theory in situated practice, something like Schon’s (1990) "theory-in-action". Ethical praxis suggests we join with clients in gauging what is useful in reference to relational ethics, rather than appealing to "Olympian, disembodied, individualistic and personally uninvolved standpoints...theoretical accounts of (assumed already) systematic states of affairs" (Shotter, 1993, p. 46. Emphasis in original). This is a commitment to a being-in-ethical-relation which, as difficult as it is to articulate, is far harder to realize. Like McNamee, Gergen et. al. (1999), I believe

Reflecting teams (Andersen, 1987; Friedman, 1995) provide an alternate means of promoting accountability by inviting a multiplicity of viewpoints, and locating them in personal and professional experience. The reflecting team calls for a public declaration of one's subjectivity, thus countering the possibility that one’s favored discourses might fossilize into "truths" that close down conversation.

A second potentially fertile exploration involves revisiting a wide range of established counselling traditions with insights afforded by contemporary theorizing. Becoming sensitive to current insights about the social construction of meaning, for example, need not lead to a flat rejection of approaches which emerged when this theorizing was is its infancy. But it is worth asking how one might adapt theories and associated practices to accommodate recent understandings. The psychoanalytic literature, for example, is rife with such explorations (cf. McFayden, 1997; Rabin, 1995; Renik, 1998). The discussion here has focused primarily on epistemological concerns, and does not begin to examine how a posture of discursive wisdom might refashion our views of, for instance, emotion or transference in relationships.

Discursive wisdom describes not so much an "alternative epistemology" as some dispositions and actions that enable us to do epistemology differently. What I have spoken on behalf of here is an approach to shared knowledge-making: an "interplay that encourages an egalitarian and mutual search for understanding" (Anderson, 1997, p.137). The point I have been most dogged in articulating is that to privilege one or the other’s knowledges is to violate the quest for conjoint meaning making (Mcnamee, Gergen et. al. 1999), and to perpetuate a relational violence. A therapy devoted to the extension of meaning seeks to include both "your knowing" and "my knowing"; it strives for an "our knowing" that transcends both.

1. While the approaches described here as contextual do not explicitly delineate specifications for health or functionality, it is a worthy question to consider to what degree those specifications may be implicit in these contemporary practices.

3. I do not mean to suggest this is the only way to make sense of what, in some contexts, is described as "anorexia". My point is that we do not escape taking a stand by declining to question discourses or practices that our judgment suggests may contribute to a person’s suffering. To remain mute in the face of apparent injustice is to renege on therapeutic responsibility.

4. This reflexivity, of course, also applies to the practices embodied by the discourses in question.