Postmodernism, Ethics, & Psychotherapy

Postmodern Ethics

           One of the most commonly voiced critiques of postmodernism is that it promotes relativism. From this perspective, it is maintained that there is no way to say that anything is wrong or immoral thus promoting an extreme moral relativism. The example offered as the condemning criticism illustrating this point is that postmodernism is unable to state the murder, rape, or child abuse is immoral.
            Hopefully, by this time, you, the reader, are able to recognize that these arguments are not an accurate or valid criticism of postmodernism. There are few, if any, postmodernists who would maintain that murder, rape, and child abuse are morally acceptable. What differs is how they go about condemning these behaviors.

Ethics and Postmodernism
            At minimum, there are three important postmodern alternatives to that of extreme relativism. First, and most simply, is a utilitarian argument based upon the Golden Rule. This approach would suggest that there is need for a social contract for society to exist. As such, because people desire to live free of murder, rape, child abuse, and other crimes, they agree to not engage in these behaviors. Although this perspective does not state that these are morally wrong, it does provide a way to provide a way to limit these from occurring.
            A second, somewhat more sophisticated perspective, maintains that ethics and morality are socially constructed. All, or nearly all, cultures of the world have prohibitions against murder and child abuse, which is often used an argument these must be knowable Ultimate Truths. However, there are a couple of limitations to this argument. For one, what constitutes child abuse, rape, and murder differs from culture to culture. For example, many behaviors that would be constituted as child abuse, rape, or murder in contemporary Western cultures have been viewed as permissible or encouraged in other cultures or Western culture at different points of history.
            Because cultural analysis demonstrates that there are cultural variants in all these themes, it can be argued that ethics and morality are always socially constructed. The similarity which arises, such as all cultures having some prohibitions around killing other people, is based on the need to construct such rules for people to survive. In other words, it develops out of necessity relevant to survival which arises in cultures, not from a Universal Truth which each culture has discovered.
            A third perspective arises from a postmodern realist or critical realist perspective. Postmodern realists purport that some Ultimate Truths may exist; however, we are not able to fully know these truths. Additionally, they generally believe that many truths we believe to be objective or universal are not. In this perspective, the immorality of murder, child abuse, and rape may very well all be Universal Truths; however, these truths cannot be fully known. This accounts for the variations in how each of these is interpreted in different cultures. Additionally, this perspective would state that while there may be some Universal Truths, many other laws or ethics codes which have been created and treated as ultimate truth (i.e., reified) are, in fact, relative or socially constructed truths.

Psychotherapy Ethics in a Postmodern Perspective
            Counseling, therapy, and psychotherapy in a postmodern perspective all could be considered socially constructed practices. These are not Ultimate realities which Freud and others have discovered. People have created each of these yet we often treat them with such reverence that it would be easy to believe there is some ultimate form of psychotherapy. This idea is reflected in many of the empiricists who seek to “prove” one therapy is the best therapy and believe that eventually science can determine which therapy is best for who at what time. When one steps back and looks at such an idea from a postmodern perspective, the absurdity of it quickly becomes fairly evident.
            If psychotherapy is socially constructed, then the ethics which govern it also are socially constructed. It can be noted that most psychologists, and definitely most governing boards of psychologists, treat the various ethics codes as if they were Ultimate Truths which they have discovered and delineated. Let me be clear, I am not proposing that we should do away with the ethics codes or simply choose not to follow them because we recognize they are socially constructed and therefore flawed. What I am proposing is that it is important for us to recognize the nature of ethics codes as socially constructed.
            Why is this such an important point? Let me propose two primary reasons. First, when we reify ethics codes in a manner so that we begin treating them as an Ultimate Truth, we no longer critically think about what is ethical; we just assume the ethics code is correct. This does not allow for the ethics code to be further refined or adapted to contextual situations, new developments, and new insights. In the end, we do a disservice to ethical living and practice when we stop thinking about ethics in a critical manner and no longer recognize that these are socially constructed truths developed in a particular culture and time.
            Second, recognizing the constructed nature of therapy is imperative to culturally sensitive practice. For example, psychotherapy in many other countries has very different standards regarding boundaries and standards of practice. I have witnessed a number of United States psychologists who have looked down on students and therapists from other cultures often talking to them in a condescending manner because they have different standards of ethical practice. Additionally, I have many times heard United States psychologists make the statement that these cultures obviously are not as evolved or enlightened in their therapeutic practice. Such statements, in my mind, are offensive and unethical.
            Ethics, in a postmodern perspective, must be understood contextually. What is ethical in one context may not be ethical in another. Let me provide an example of this. In the United States, there are strong prohibitions about touch in therapy which are not present in other cultures. In general, people in the United States, particularly Caucasians, tend to be less comfortable with touch. Given this, it is more likely that these same people would perceive or experience non-sexual touch as abusive. In other cultures, where the same touch is more acceptable, touch may be therapeutic.
            In the United States, many therapists and governing boards strongly discourage touch. This has translated into encouraging people practicing in other countries to do the same. However, it could also be argued that people in the United States have a touch phobia or a tendency toward pathologically fearing touch; therefore, working through this should encourage touch in psychotherapy. From a postmodern perspective, this could be a valid critique of psychotherapy in the United States.
            Again, I am not encouraging therapists to engage in touch in therapy. This is a decision that each therapist practicing needs to consider in the context of regional and national ethics codes, standards of practice, and personal comfort along with consideration to individual client’s needs and values. What I am encouraging is for therapists to think about touch contextually and critically.

A Postmodern Approach to Ethical Practice
            In this section, I will propose two approaches to ethics: an ideal and a practical. In practice, I would encourage therapists to use the practical approach. However, I think the ideal also has important concepts for therapists to consider when making ethical decisions. Let me preface in stating that this is a very general overview and each perspective needs further development. In this section, by ethical I mean that which serves the client’s greater good and goals as collaboratively defined by the client and the therapist.
            A Postmodern Ideal. Ideally, all ethical decisions should be considered in the personal, social, cultural, and theoretical context. By personal, I mean personal factors with both the therapist and the client. What is ethical practice for one therapist may not be ethical for a different therapist; similarly, what is ethical with one client may not be ethical with another. By social and cultural, I mean that there are factors in the immediate social context as well as cultural context that help determine what is ethical. Finally, by theoretical I am advocating that what is ethical and considered best practices must be considered in the context of the theoretical orientation or approach to therapy being applied.
            The essence of this ethic is that it is contextually driven toward a goal or goals which are mutually agreed upon by the therapist and client. These goals are flexible and may grow and change as therapy progresses. As is evident, this idea is very ambiguous and abstract making it difficult to apply. For this reason, a more practical alternative may be beneficial.
            A Practical Postmodern Alternative. Delineating an ethics code, instead of relying upon more flexible general ethical principles, is a concession to make ethics more practical, easy to enforce, and better able to protect clients from therapists with harmful intentions. It is helpful to keep in mind that the principles, though more ambiguous, reflect a higher, though less clear, ethic. A more pragmatic postmodern approach to ethics relies upon this understanding.
            In this concession, the ethics code takes on a higher priority. It is the responsibility of the ethical postmodern therapist to do their best to follow the ethics code governing their local practice unless doing so may cause harm to the client. In such a situation, it is imperative that the therapist consult with other professionals and the appropriate governing bodies. This is particularly important with the recognition that it is possible to personally construct anything as ethical.  However, as much as possible, the therapist should continue to take into consideration the personal, social, cultural, and theoretical context.
            The examination of the personal, social, cultural, and theoretical context will at times, maybe often, point out limitations in the ethics code. At such times, the postmodern therapist should seek to address this in the psychological community in order to promote change and greater sensitivity. By engaging the professional community, he or she engages the social constructive aspect of ethics. This engagement is important in the distinction between an ethics which promotes a moral extreme relativism and a socially constructed ethics.
            It may be evident that the ideal reflects an understanding of ethics that is very similar to higher levels of morality in Kohlberg’s theory (stage 6) with some constructivist revisions while also bearing some similarities to Gilligan’s alternative to Kohlberg, which is built upon a feminist critique. The more practical alternative reflects a lower level in Kohlberg stages (stage 5) which may be necessary given social realities.

Conclusion
            Ethics are ambiguous and difficult. Any attempt to simplify ethics to a code or list of rules and prohibitions will create problems. The postmodern perspective on ethics developed here suggests that a more practical compromise between the very abstract, ambiguous principles and the more concrete, overly-simplistic ethics code is needed. While this is less than ideal, it provides a framework for postmodern therapists to balance their postmodern ethical sensitivities with a field that often relies on more concrete ethical codes which lack needed sensitivity to contextual issues.

Added December, 2006
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