ethics

“When Clients are Grieving” CEU ethics workshop in Houston (Friday, December 4, 2015)

R. Horton

We are offering a workshop on the ethics of grief on Friday, Dec. 4, from 9 a.m. till noon. We will be exploring proper responses to grieving clients. Most therapists accept the dictum that “There is no wrong way to grieve,” but we will look at extreme cases such as homicide and self-destruction and search for the “bright line” between good and bad grief. We will then frightening2-800pxask whether “bad grief” is unethical or merely unhealthy. We will examine the ethical response to “bad grief” and explore whether men and women should respond to grief differently.

The workshop is open to anyone, but we offer 3 Continuing Education Units (CEUs) to Licensed Professional Counselors, Licensed Marriage and Family Therapists, and Licensed Clinical Social Workers.

The cost is $25.00.

For more information, write randall@ethicsbeyondcompliance.com

From Xu Mu to Donald Trump: Do We Need An Ethics Just For Women?

R. Horton

In the second GOP debate, candidates were asked an inconsequential question about what woman they would want to see on the $10 bill. Three mentioned family members who were caregivers and one mentioned Mother Theresa. Other candidates did mention women who were political leaders, but it is worth noting how difficult it is for some to imagine, even now, a great woman who is not caring for others. Rather, it is still hard for too many people to imagine that leading and fighting for justice and rights is a form of caring for women that is worthy of admiration.

The idea that women should be good, as women, but not in the same way that men might be good, is about as old as civilization. Men have placed women in an impossible bind forever. For striving to be the best person possible, they are often denounced, attacked, or even murdered for stepping above their station. In the seventh century BCE, Chinese poet and princess, Xu Mu found herself in a position where she felt she must defend her kingdom (Wei) against the Di people (see Barbara Bennett Peterson’s essay about dutiful daughters of ancient China here). She successfully rallied her brothers and friends from neighboring kingdoms to preserve their home.

A man in her position would simply luxuriate in the waves of honor and gratitude flowing over him, but Xu’s position was more complicated. She is remembered for her chinese poetaccomplishments, but she also faced the wrath of the men in her community. She recorded her mixed experiences and feeling in a poem, “Speeding Away”:

Harshly though you may judge me,
From my course I will not veer.
Compared to your limited vision,
Do I not see far and clear?

Harshly though you may judge me,
My steps you never can stay.
Compared to your limited vision,
Am I not wise in my way?

I’ve climbed the heights of A Qiu,
Gathered herbs on the slope alone.
All women are prone to sorrow,
Each follows a path of her own.
The people of Xu still blame me,
Such ignorance has never been known.

Out of necessity, she stepped out of the role of good wife, daughter, and mother to save her homeland only to be criticized, but she didn’t accept the criticism. She said, “O listen, ye lords and nobles, Blame not my stubbornness so,” but she was denied the opportunity to emerge as an unvarnished hero. If she had been a man, she would have been good, but she could not be considered a good woman without qualifications. Her society had two concepts of virtue: one for men, and one for women.

A couple of centuries later, Plato advocated for a single measure of virtue and goodness. He felt that the ideal form of the good was universal, so it wouldn’t make sense for some people to aim at one ideal and others at another ideal, as there can only be one ideal. Consequently, women and men should aim at the same ideal, and men, just by chance, seem to have an easier time getting close to it. In Plato’s Republic, women would be trained and educated in the manner of men in hopes of achieving their highest possibilities of human perfection. Women who succeeded in being the most like the best men would be the best women. Men who resembled women, on the other hand, were the worst of men. In Plato’s world, then, Xu Mu might be admired for embodying the virtues of men, but she may still be censured for failing in the virtues of womanhood.

Plato’s unusual conception of a single standard for virtue for men and women didn’t last long. His student, Aristotle, found insistence on a single standard for goodness unnatural and unfair. Men and women, being different, should strive for different ideals. A woman should be a good woman and a man should be a good man. To judge a woman on her ability to be like a “good man” would be as absurd as judging a musician on his ability to make good shoes. Women should do what is right and natural for them, he believed. Under Aristotle’s guidance, Xu Mu would do better to leave saving the kingdom to the men, who would be more rational and better prepared for war.

Those who feel women have different strengths than men will insist that they are not misogynistic. No, they love women for the things women do best. These men (and women) say that women have civilized men, make peace in families, and rear children for greatness. They love their mothers, wives, sisters, and daughters as they make it possible for men to achieve greatness in war, politics, business, science, and philosophy. For example. Ronald Reagan explained his high regard for women by saying, “If it wasn’t for women, us men would still be walking around in skin suits carrying clubs.”  The problem is that the things these men suppose women excel at doing are also denigrated by society precisely because women do them, which means that women are devalued as well. In the third century BCE, another Chinese poet, Fu Xuan, summed up the problem nicely:

How sad it is to be a woman!!
Nothing on earth is held so cheap.
Boys stand leaning at the door
Like Gods fallen out of Heaven.
Their hearts brave the Four Oceans,
The wind and dust of a thousand miles.
No one is glad when a girl is born:
By her the family sets no store.

By this measure, to be the best woman possible is still to be something inferior to even a mediocre man. Women may not attain the highest levels of virtue.

Upon reading the works of many men claiming that women are inferior at birth, Christine Pisan, wrote a rhetorical query to God in 1405 CE:

“Alas, God, why did You not let me be born in the world as a man, so that all my inclinations would be to serve You better, and so that I would not stray in anything and would be as perfect as a man is said to be? But since Your kindness has not been extended to me, then forgive my negligence in Your service, most fair Lord God, and may it not displease You, for the servant who receives fewer gifts from his lord is less obliged in his service.”

Trapped in a paradox, extreme virtue is demanded of women while it is simultaneously denied them. By asking God to resolve the paradox, Pisan brilliantly illustrates that it is men, not God, who created the paradox, for no God would be so irrational. The binary is not only absurd; it is impossible.

In 1694 CE, Mary Astell eschewed literary maneuvers and stated directly that men are to blame for the situation of women. In her Serious Proposal to the Ladies, she remarked, “That therefore Women are unprofitable to most, and a plague and dishonour to some Men is not much to be regretted on account of the Men, because ’tis the product of their own folly, in denying them the benefits of an ingenuous and liberal Education, the most effectual means to direct them into, and to secure their progress in the way of Vertue.”  She goes on to say, “For since God has given Women as well as Men intelligent Souls, why should they be forbidden to improve them?” Astell issued a call to arms for women. Many have responded, and continue to respond.

In the late 19th century, Mary Wollstonecraft repeated the call: “To account for, and excuse the tyranny of man, many ingenious arguments have been brought forward to prove, that the two sexes, in the acquirement of virtue, ought to aim at attaining a very different character: or, to speak explicitly, women are not allowed to have sufficient strength of mind to acquire what really deserves the name of virtue.”  Wollstonecraft argued that two standards of virtue only serve to cement the power of men over women. A single standard will liberate both.

Simply choosing between a singular or dual ethics does not resolve the problem of misogyny, masculine power, or the systematic devaluing of anything “feminine.” If we choose to embrace a single ethics, the default position is to embrace the ethics previously associated with “masculine” virtue. To do so, women must themselves then disparage “feminine” virtues, which will mean debasing the activities traditionally associated with women. Thus, both women and men engaged in such pursuits are permanent held in reduced stature.

On the other hand, to embrace a dual system of ethics is to preserve the status quo. The male system of ethics continues to be the good and noble ethics while the female ethics is valued only for its contributions to maintaining the power and worth of male activities.

A single ethics that values all virtues and activities that are, in fact, valuable demands a complete deconstruction of gender and power so that it can be replaced with a non-binary system that embraces and venerates all activities that aid human flourishing. If nurturing children is a good, then it is good for both men and women. Such a system can have no concept of “women’s work” or “men’s work.” The idea that activities or dispositions (caring, assertive, protective, sensitive) are “masculine” or “feminine” must become a foreign idea. This will require radical resistance. Xu Mu and others like her began this battle nearly 3,000 years ago. After watching the second GOP debate, I believe it may take another 3,000 years to finish the war.

Attribute Substitution and Public Health

R. Horton2 Comments

Partly in response to a series of posts in the New England Journal of Medicine dealing with conflicts of interest in medical research, Austin Frakt wrote a piece for the New York Times titled, “A New Way to Think About Conflicts of Interest in Medicine.”  In the end, he claims that too many critics dismiss a study simply because it received industry funding, and he says this is a kind of attribute substitution (this is a fallacy whereby something may be rejected because it is associated with something negative, rather than on its own merits).

This is a bit of red herring, because attribute substitution is not always such a bad thing. If I am negotiating to buy a new car, it may be that everything checks out regarding the engine, interior, paint, brakes, and so on, but I may reject the car simply because I happen to know it is stolen. The fact that it is stolen doesn’t make it a bad car, but it does make it spectroscopeone I would not want to buy. In the same way, the fact that a study is industry funded does not prove it is a bad study, but it is possible for a reasonable person to object to it simply on the grounds that its funding encourages unethical behavior.

Also in his essay, Frakt mentions that research is often tainted by many things that are not industry funding: things like personal relationships, religious bias, and overweening personal ambition. On the other hand, industry-funded research often yields excellent, well-controlled studies with beneficial results.

All this is true, of course, and there may be critics out there who believe that no industry-funded research should be published, but I think that is an unusual view. What is more common is to call for disclosure of financial ties to industry. With such disclosure, readers can evaluate the data with an understanding of the possible bias of researchers. More importantly, in my opinion, is that disclosure helps us see whether anyone from outside of industry is working on the same problem.

Disclosure does nothing to eliminate bias. If I know that someone is working for Pharma Co. X, I know she is trying to develop profitable products for her employer. The best path to a high profit is probably through rigorously controlled research. The bias of the researcher is to develop a profitable product, and disclosure will not change that bias; it isn’t a conflict of interest as profit is really the only interest driving the research.

The problem is that most research is now funded by industry (in 2012, industry funded about 59 percent of medical research in the US).  When researchers are hired to create marketable products they are, indeed, motivated to show bias both in how they conduct their research and in what kind of research they begin in the first place. Unethical practices can happen both within and without industry, but we are better to have a variety of ways to fund research, and we are better to have transparency about how research is funded and how it is conducted. We need to know how research participants were recruited. We need to know what data was and was not used. On the issue of transparency, I agree completely with Frakt: “To the extent research design and methods are not up to snuff, that’s the red flag — the door through which conflicts of interest enter and exert undue influence. More rigorous, transparent and reliable research from both industry and nonindustry sources would reduce the need to lean so heavily on mental shortcuts like attribute substitution in judging scientific merit.”

Finally, we need to know whether research was aimed at reducing human suffering or merely at generating profits. On a good day, these two goals are perfectly aligned. On a normal day, reducing human suffering is at odds with creating products. I’ve mentioned before philosopher Thomas Pogge’s efforts to create incentives for companies to develop drugs for conditions that may not be profitable, and I think it is worth mentioning his Health Impact Fund once again. Pogge’s solution is one that works fairly well with market-based thinking. Love it or hate it, it is a good effort. Other solutions are possible, though. Governments could pool resources to simply set up labs and hire scientists to develop cures for diseases that affect global health. Capitalist investors might also want to develop cures in order to capitalize on improved human resources as John Rockefeller did about a hundred years ago.

Yes, I realize government funding and charitable institutes still exist (Rockefeller’s legacy continues), but research for profit (and only for profit) threatens our ability to continue advances in public health. We need greater transparency (of financial ties and data transparency) in research, greater protection for research subjects, more variety in funding sources, and more checks to replicate and confirm findings. It may be expensive, but mistakes are expensive, too.

Therapy: The Poison of the Phrase “Usually the Man”

R. Horton3 Comments

When Charles Dickens wrote Oliver Twist, he never bothered to make mention of the race or religion of any of the characters, except one. Throughout most of the novel, Fagin is referred to as “The Jew” with occasional variations on the theme. You may think his choice of words was simply standard at the time, but he was challenged on this choice. When criticized, he seemed surprised, and said, “It unfortunately was true, of the time to which the story refers, that the class of criminal almost invariably was a Jew”. He said he wasn’t biased against the Jews but was merely reflecting a simple truth about the nature of certain criminals. He even exclaimed, “I have no feeling towards the Jews but a friendly one. I always speak well of them, whether in public or private, and bear my testimony (as I ought to do) to their perfect good faith in such transactions as I have ever had with them…”

He really couldn’t see that any of this was his fault, but he eventually did change his ways. 11163694886_802d9911b7_zHe did have actual Jewish friends, and as hard as it was for him to see the problem, he didn’t want to offend them. He explained, “There is nothing but good will left between me and a People for whom I have a real regard and to whom I would not willfully have given an offence.” In the last chapters of the book and in subsequent readings, he deleted the offending appellation in the way you might finally discard a favored but hopelessly stained garment.

Dickens wasn’t unique by any means. We all have biases that we feel certain are nothing but statements of fact, supported by our frequent observations. In my interactions with therapists, I often hear the phrase “usually the man” sprinkling their descriptions of couples with marriage difficulties. Something like this: “When one partner has difficult expressing emotion (usually the man) . . .).” Or, “When one partner struggles with monogamy (usually the man . . .). Or, “When one person is addicted to porn (usually the man . . .). I’ve asked a few therapists about this construction, and the response is always some variation of, “What am I supposed to say when I’ve observed this time after time in my office?”

The fact is, of course, when we believe something is true, we tend only to take note of that occurrence in our observations. Even when we are aware of our own confirmation bias, it is exceedingly difficult to diagnose our own blind spots.

Some examples:

  • Dr. Gerald Stein, listing several kinds of unhealthy sexual activities, describes “selfish sex” as “a cousin to Obligatory Sex. However, in this example, it is usually the man who satisfies himself quickly, not out of duty, but simply because his needs are all that matter to him.” Note that it is usually the woman who has sex out of a sense of obligation, or so Dr. Stein believes.
  • In a paper by Barry McCarthy on marital sex, he says, “A realistic expectation is forty to fifty percent of sexual experiences will be satisfying for both people, twenty to twenty-five percent are very good for one partner (usually the man) and good for the other.” He begins the paragraph by saying the data is empirical, but only cites a study on sexual dysfunction that occurs before the statistics about satisfaction, which is not cited. I’m sure his experience confirms his claims to his satisfaction.
  • An article on domestic violence in Psychology Today by Neil S. Jacobson and John M. Gottman says, “In many unhappy marriages, when one partner (usually the woman) requests change, the other one (usually the man) resists change, and eventually the woman’s requests become demands, and the man’s avoidance becomes withdrawal.”  Again, if asked, I am sure these therapists/researchers would insist that their statements are supported by many hours of clinical observation, and they probably are; however, it is likely that men who are victims of domestic violence are much less inclined to seek therapy because they know they will not be taken seriously as victims or because they also refuse to see themselves as victims.

I could go on and on with examples, but you can do it yourself. If you want to see how pervasive this phrase is, just Google “psychotherapy” and “usually the man” or “marriage counseling” and “usually the man.” I promise, you will have plenty of examples.

What I would like to point out is that these “empirical” claims about what men do in relationships always conform to negative stereotypes about men. Men are selfish lovers. Men are abusive partners. Men are kinky. Men are more easily satisfied sexually than women. This thinking eliminates the opportunity for men to be abused, neglected, unloved, and unfulfilled. It denies women the opportunity to be the partner who is more sexual, more liberated, or more powerful. I once sat through a panel discussion by three male therapists, and one of them admitted that his sympathy just naturally went to the women when he saw heterosexual couples.

A couple of things to consider:

First, it may be correct that in some cases men are more likely to exhibit certain behaviors or attributes than women, but assuming they do makes it extremely difficult for you to see the men who are atypical. Second, it may be that men and women are not as you perceive them to be at all. Rather than interpreting data as it appears, you may be constructing data from your own biases.

A final note:

If you wonder whether your statements may reflect a bias or stereotype, try the Dickens test: Substitute “usually the Jew” or other racial term for “usually the man,” and see how it sounds. If you aren’t comfortable with the racial term, consider revising both your words and your expectations of your clients.

The Ethics of Professional Ethics

R. Horton

When I was defending my dissertation a few years ago, a committee member asked me how I would respond to a tobacco company who asked me to advise them on the most ethical ways to harvest tobacco grown on farms in South America. I first answered, honestly, that I couldn’t imagine working for a tobacco company, but then I added that the only advice I could think of would be to choose a more ethical product in the first place and then worry about fair treatment of workers, protection of the environment, and so on.

It would, of course, be difficult to make a living as a professional ethicist if you simply Briberyadvised all your clients to go out of business. Accepting a paying job creates a financial conflict of interest from the beginning. If you want to keep your job, you will immediately know the parameters of your possible advice. In the worst case, you will simply be giving rubber-stamp approval to the activities of your boss. In the extreme case of a tobacco company, this conflict may be clear, but other conflicts are much less obvious.

The best problem for an ethicist to have, I think, would be an opportunity to work for a company or organizations with the same goals and values of the ethicist. It would make sense for a vegan ethicist to want to work for a company that sells cruelty-free products. If the company hired an ethicist to determine what practices ere ethical, it would be a perfect situation, but this is a case of an organization seeking out an ethicist whose conclusions are already known. This is hardly an ethics consultation. And just to vary the scenario a little, it is unlikely that a Catholic-owned organization is going to want to hire an ethicists who does not believe in the sanctity of life just as an organization providing contraception services would not want to hire a Catholic ethicists. If you can simply shop for an ethicist who agrees with your actions beforehand, there is no point in hiring an ethicist.

In some cases, companies really do want to seek expert advice on how to proceed on various products and actions. They seek out, naturally, ethicists who share their overall values but have additional training and demonstrated expertise in evaluating ethical quandaries. When helping some one choose between X and Y, ethicists can make a fairly objective evaluation, given that neither choice is presented as the preferred choice. Rather than “Have we been ethical?” the organization is asking, “Which of these two choices is the most ethical way to proceed?” In this case, asking more than one ethicist would seem advisable. Then, the organization is still responsible for its decision, but it is based on more (and more nuanced) information. Still, it is possible for people to use the ethicist for moral cover (“Hey, the ethicist said it is ok, so there!). Providing moral cover for your employer is just never going to look good.

Ethicists can proceed, though, by offering a thorough analysis without necessarily giving a green light to any particular action. With so much training behind them, ethicists should be well prepared to answer questions about agency, autonomy, rights along with background information on previous cases and debates. We don’t need to reinvent the wheel each time a new problem arises.

The professional ethicist can help with questions such as:

  • What are violations of autonomy?
    Is autonomy the only concern?
    What is the importance of narrative in moral decision-making?
    Do men and women operate with different moral frameworks?
    What are moral agents?
    Who is (or should be) of moral concern?
    What is the importance of virtue in organizational ethics?
    Is care necessarily part of ethical deliberation?
    What are positive and negative rights?
    Which moral choices are obligatory and which are supererogatory?
    What is the difference between human rights, human development, and human capabilities?
    Who is responsible for justice?
    Must ethical decisions be impartial (do family and friends matter more)?

Ethical Codes: Moving beyond autonomy

R. Horton

Ethical theories can be divided in a number of ways, but one easy way is to separate the rule-based theories from theories that are not rule based. If you happen to be writing a code of ethics for your organization, you are going to drift toward rule-based theories because, in fact, you are writing a set of rules. These rules are important to ensure and protect the professionalism of your organization or profession. Ethical codes, made up of rules, establish a system of accountability for your members. Ethical codes are useful and often essential for professional organizations and vocational fields.

The rules in professional codes tend, whether stated or not, to focus on autonomy as begging devildefined by Immanuel Kant. His advice is generally interpreted somewhat loosely to say that we should only do to others what they have chosen to have done to them and use them only in ways that help them achieve their own ends. We should not use others only as a way to achieve our personal goals.

Based on this thinking, we would only provide people with treatment after receiving their fully informed consent, we would use people in our research only if they wanted to participate, and we would always be honest with clients and work in their best interest. Some would be a little shocked by the full implications of Kant’s views. For example, to have sex without the intent to procreate is to use both yourself and your partner as a mere means to pleasure. Lying to a murderer in order to save a child’s life would lead to you being charged with a crime in the event of the child’s death.

When it comes to integrating ethics into your professional practice, however, you may find rule-based systems too limiting and seek a theory that feels more inclusive of your entire professional life. It may help to look at two other groups of ethical theories: 1. Theories that focus on what kind of person to be. 2. Theories that focus on how to relate to others. This isn’t a neat division as these two types of theories overlap in significant ways, but it can be a useful starting point.

Virtue Ethics

Friedrich Nietzsche rejected rule-based systems of morality, which he referred to as forms of “slave-morality,” for morality aimed at character, which he called “master-morality.” He said, “It is obvious that moral value distinctions everywhere are first attributed to people and only later to actions.” For Nietzsche, it is the powerful who will see moral behavior as a by-product of being a great person while the weak will seek moral rules to protect their interests from others. Nietzsche suggests we should all strive to become great people rather than subjecting ourselves to the rules and will of others.

In a similar vein, Aristotle saw morality as a process of becoming a good person rather than following a set of rules, though he did say that things like theft, adultery and murder are always wrong, allowing for the existence of some moral rules. In general, though, a person becomes good, not by following rules, but by developing a virtuous disposition. This approach does emphasize activities, as it is through our actions that we develop our character. By choosing the actions a good person would choose, we become a good person, and by being a good person we tend to choose actions that are also good.

Relational Ethics

If you work with people on a regular basis, you may find a theory based on relationships conducive to moving beyond rule-based systems and ethical codes.

In the past, I didn’t really think of existentialism as a good foundation for a relational ethics as many existentialists focus on subjective experience, but Simone de Beauvoir’s “Ethics of Ambiguity” changed my mind. Beauvoir specifically tackles the problem of making ethical choices in an ambiguous world. Contrary to Immanuel Kant, she says it is not possible to arrive at certain rules to guide our behavior, but this does not mean we can shirk our obligation to act with concern for others.

Beauvoir says we experience life through our own experience by exercising our own freedom, but we do not experience it in isolation. If we do experience it in isolation, she says, “The saving of time and the conquest of leisure have no meaning if we are not moved by the laugh of a child at play. If we do not love life on our own account and through others, it is futile to seek to justify it in any way.” Our authentic self is expressed through free acts, but “[The individual] exists only by transcending himself, and his freedom can be achieved only through the freedom of others. He justifies his existence by a movement which, like freedom, springs from his heart but which leads outside of him.” Though our actions can’t be pinned down by a set of rules, we find meaning in life by seeking, willing, and nurturing the freedom of others in the world. In a sense, our affirmation of freedom is an exclamation of love.

Love may not seem an appropriate emotion to mention in a discussion of ethical relations with clients, but we don’t have to think of it in romantic or sexual terms. Love may be a matter of valuing others. Philosopher Martha Nussbaum argues that love is an essential feature of a liberal democracy. Some might quibble over how she defines love, but certainly it is a concern for others that drives both the ethics and political struggles of some of us. For example, she notes that we all live in a state of dependency at one time or another (childhood, old age if we are lucky to live long enough, and periods of impairment). Some of us live in states of dependency for our entire lives. Protecting the dignity of all requires us to recognize the value in others, and love for others is sufficient motivation to remove the shame and stigma of dependency. Our concern for others motivates our most basic moral impulses.

In this sense, both Beauvoir’s and Nussbaum’s views can be seen as forms of an ethics of care. If you are familiar with care ethics, though, you probably heard of it through the work of feminists such as Carol Gilligan and Nel Noddings. Care ethics was introduced as an alternative to theories seen to value men’s experiences over women’s. Feminists pointed out that women’s experiences have largely centered on care. Some will say caring is natural to women and others will say women have been forced into caring roles.

Over time, care ethics has become somewhat less gendered, meaning both men and women may recognize the value of care in their ethical lives. Noddings says our moral obligations arise between the “one-caring” and the “cared-for.” The response of the “cared-for” drive our actions. The most debilitating kind of existence, she says, is to care for someone who is unable or unwilling to respond to care. Controversially, she says, “We are not obliged to act as one-caring if there is no possibility of completion in the other.” This means are have no obligations to “the needy in the far regions of the earth.” Philosopher James Rachels objects, saying, “A more sensible approach might be to say that the ethical life includes both caring personal relationships and a benevolent concern for people generally.”

Some philosophers see narrative ethics as a logical extension of an ethics of care. Narrative ethics emphasizes the role of stories in our moral lives. Most of us grew up hearing “didactic stories” about foxes and wolves and so forth that left us to learn “the moral of the story.” This is an important feature of narrative ethics but stories need not be didactic to aid our moral reasoning or impulses. We may also learn from both fiction and true personal narratives.

Fiction can help us broaden our imagination of what life is like for others. It helps us to understand feelings and motivations outside our own experience. It gives us a way of testing different points of view and outlooks. Similarly, listening to or reading the accounts people give of their own lives gives us greater insight into their emotional lives and helps us to develop an empathetic response. Our moral obligations and intuitions look quite different when we are better able to “read” the minds and motivations of others. Those who work intimately with clients on a regular basis are immersed in their stories. In this sense, ethics is integral to the practice. I personally think it is helpful to think of ethics as being embedded in our work rather than a separate function that requires attention outside of our “real job.”

Again, autonomy plays an essential role in developing ethical codes of behavior. If we fail to respect the autonomy of others, we violate them in ways that are always wrong and often illegal. Still, other ethical approaches can expand the role of ethics in our practice and help us pursue ethics that really is beyond mere compliance.

Calling out privilege and ignoring hidden identities

R. Horton

It is predictable. A woman or a gay person or a person of color tries to describe their own experience, and along comes a straight, white male to explain why their experience is all wrong and how the world really works. This egregious “mansplaining,” as it has come to be known is decried, and the perpetrator is publicly pilloried. Or something like that.

In one sense, I’m all for public shaming of people who are shameless. I like for people who are smug and self-satisfied to be provoked and put under the lens of public scrutiny. I agree that “mansplainers” need to learn to listen for change instead of lecturing constantly. HideHowever, I think a little caution is needed. No, I think we should all just stop and try to have respectful conversations. I think this for one simple reason: It is impossible to tell what a person’s experiences are without engaging them in conversation. Yes, being male gives a person some privileges. Yes, being white gives a person certain privileges. Yes, being heterosexual gives a person some privileges. The problem is that it is impossible to look at someone and even tell whether they are white, male, or heterosexual or whatever.

Yes, I suppose it is a privilege to be able to “pass” as someone with privilege, but many people find their own privilege limited or restricted by factors that may be invisible to you. Such as:

Race: You may also think of race as a biological fact, though there is no biological determinant for race, it is not always possible to tell someone’s race by looking as evidenced by an exchange between Jay Smooth and Nancy Giles of CBS Sunday Morning. Giles accused Jay Smooth of “talking black” to attract a black audience. Smooth let her know that he is “actually” black.

Atypical gender: You may have the idea that gender is a biological fact, and you may think you know what transgender men and women look like, but there is really no way to tell what someone’s biology is, much less what someone’s identity is. The person you are seeing may be a transgender man, a transgender woman, or a person who simply does not fit gender binaries. Some people say that people who grew us “as boys” were socialized to accept male privilege. If you believe that transgender girls, forced to live as boys, accept and benefit from male privilege, you should read accounts of what life is like for these children.

Sexual minorities: You may think your “gaydar” is excellent, but it isn’t really possible to identify sexual minorities by looking at them. Many victims of anti-gay attacks and bullying are not gay, and many people you assume to be straight may not be. Some married people are bisexual, and some people consider their sexuality to be fluid.

Religious minorities: We know that many Americans hate and fear anyone they suspect may be Muslim, regardless of what religion the person may actually practice, but all religious minorities are subject to scorn and harassment. More Americans say they would vote for a gay candidate than an atheist, and 40 percent of self-identified atheists and agnostics say they have experienced some from of prejudice or discrimination. As a result, many members of religious minorities live with secrets and not as their authentic selves. This doesn’t rob them of the privileges they have, but it does give them an understanding of oppression.

Sexual assault survivors: I once had a conversation with a therapist who said that women needed to speak up about their experiences of sexual abuse because we need to hear from the actual victims, not men. I was astonished that she actually believed that almost no sexual abuse victims are men. This was a few years ago, and I think there is more awareness of male survivors now (thanks to articles like this, but the prejudice against them remains. While talking to a man, it is not safe to assume he is not a survivor of sexual abuse or assault. It is further not safe to assume that his abuser, if he had one, was male. When you blithely declare that men have the privilege of not worrying about being raped, you may be speaking to a rape victim, and you should keep that in mind.

Victims of domestic abuse and violence: Male victims of domestic abuse and violence are put in an almost impossible position.  If they speak up, people will say they are big enough to defend themselves against a woman (despite the fact that not all men are stronger or bigger than their partners). If they do defend themselves, they are perceived as the attacker, and when violence occurs, it is usually men who are arrested. They may seek allies among female victims, but they are rarely welcomed or offered services that are available to women. Further, much domestic abuse is in the form of economic abuse, emotional abuse, and verbal abuse. Given that such abuse of men is comedic fodder in television and movies, it is next to impossible for men to gain support. One of the most difficult challenges for male victims is the denial of victimhood that results from perceived privilege that is not there.

Disease/Disability: To become ill or disabled is to lose a degree of autonomy. Loss of autonomy makes anyone susceptible to oppression. Disease and disability may be visible but may also be invisible. It is impossible to tell by looking who is suffering from either, and it is equally impossible to tell who is being oppressed as a result. When we are injured or ill, we are at greater risk for manipulation, emotional abuse, financial abuse, sexual abuse, and assault.

Poverty: Poverty is the great equalizer. I understand that poor men may have a different experience from poor women and that certain races experience poverty somewhat differently from other races, but poverty is oppression, and those who have experienced oppression have a shared vernacular and an expanded empathy.

I realize that certain kinds of privilege carry over into all aspects of life. For example, a white male victim of domestic abuse may have advantages over a non-white victim. I do not want to deny privilege in any setting or argue that it doesn’t exist. What I know, however, is that those who experience oppression have a common experience that can lead to better understanding. Rather than shutting someone down when he speaks, it may pay to assume that many men have experienced oppression and do, indeed, know something of its harmful effects. It also pays to remember that people you assume to be men may not be men (either by biology or identity) and that people you assume to be white may not consider themselves white.

One final note: Sometimes people say that people with hidden identities should disclose them upfront. People have a right to decide for themselves when, where, and how often they want to disclose personal information. You have no right to make assumptions about them or to demand disclosure. No one is required to speak as “a person with cancer” or “a transgender woman” or “victim of domestic abuse.” These facts about a person need not be that persons complete identity or defining feature. We are part of the same human community. Can we just acknowledge that?

Four Ways to Grieve Unethically

R. Horton1 Comment

My wife and I recently led a discussion on the ethics of grief with a group of psychotherapists. Wishing to challenge the claim that there is no wrong way to grieve, I asked the group to consider boundaries they would place on proper and improper grieving. For the most part, they were a cooperative group, but they were certainly reluctant to declare any way of grieving to be unethical or wrong. Sometimes our conditioning is strong. When the workshop was over, one of the participants asked me what sorts of grieving I think are unethical or inappropriate.

My answer is really simple. I think you are clearly grieving unethically if you let your personal pain compel you to hurt others. I also think you are grieving unethically if you let your personal pain compel you to hurt yourself, but I don’t think that claim is so obvious as the first one.

Some examples:

  1. Homicidal rage—I’m not saying this happens often, but someone overcome with grief Embodiment-of-revenge-by-Roneswho goes on a killing spree is acting unethically for sure. After Ivan López opened fire at Ft. Hood military base, killing three and wounding 16 others before killing himself, friends speculated that it was a reaction to grief over his mother’s death.
  2. Lying and cheating—In her book, Wild, Cheryl Strayed described the emotional turmoil she experienced in the wake of her mother’s death. In her agony, she turned to casual sexual relationships and substance abuse for comfort, tearing apart her marriage and leading her to lie to her husband and other family members. She eventually found better means of coping, of course, but she still regrets the pain and harm she caused those who loved her.
  3. Alcohol and other drugs— The philosopher, Bertrand Russell, took a fairly standard Stoic response to grief, saying it is acceptable to grieve so long as it is not to excess. He says we should distract ourselves from our grief with other pursuits, so long as they are not harmful to us. In his words: “I do not of course deny that a man may be broken by sorrow, but I do say that every man should do his utmost to escape this fate, and should seek any distraction, however trivial, provided it is not in itself harmful or degrading. Among those that I regard as harmful and degrading I include such things as drunkenness and drugs, of which the purpose is to destroy thought, at least for the time being.” Self-harm is harm, and we do have ethical obligations to care for ourselves.
  4. Demanding but not offering emotional support—Many people repeat an unsubstantiated claim that most parents who lose a child will divorce within a year of the child’s death. This claim is not substantiated by any sort of study and seems to be more intuition than anything else. Nonetheless, it is true that some people who are overcome by grief are unable to provide emotional support to others even though they are receiving and expecting emotional support from those same family members or friends. It is a special kind of cruelty to ask someone in the vice-grip of unimaginable grief to provide emotional comfort and support while being left to drown in sorrow alone and adrift. If you find yourself overwhelmed by grief and unable to provide support to the rest of your family, please help them or at least permit them to find other sources of support. If you can’t provide what they need, at least do not become an obstacle to their mental health and comfort.

Anyone who has grieved has probably felt judged for his or her style of grief. As a result, we rush to say that there is no wrong way to grieve, but this bold (and wrong) assertion prevents us from having discussions about the correct ways to grieve. When our grieving causes harm to others or ourselves, it is not merely unhealthy—it is unethical.

A conversation about ethical grieving is worth having, and we can have it without shaming those who are suffering from grief. We can improve our own grieving and our reactions to grief if we can establish an ethics of grief that seeks a path to greater collaboration, greater care, and greater health. Grief will never be easy, and it will always come with risks, but an open conversation can help us avoid its worst effects.

Why I Hate Valentine’s Day

R. Horton1 Comment

Last year, I wrote a short essay on why I hate “Steak and BJ Day,” which is that it is built around sexist stereotypes and highlights relationships as transactions, consisting men giving gifts in exchange for red meat and sexual favors from women. Indeed, the idea of heartmanSteak and BJ Day (March 14) was to repay men for their generosity to women on Valentine’s Day. After being so kind to women with flowers, chocolate, and diamonds (or whatever), men deserved a day devoted to the kinds of things they like (ugh!).

Valentine’s Day is less crude and less obvious, but it still reinforces and exploits gender stereotypes. You might object that Valentine’s Day is a day for couples to express their love for one another equally, and I’m sure some see it that way, but men spend, and are expected to spend, far more money on Valentine’s Day than women. The implication is that men who buy lavish gifts will receive rewards of affection and sex. Satirist Andy Borowitz succinctly captured this relationship when he posted this:borowitz
I really object to the gender stereotypes that say women just want chocolate and flowers from men and will reward men with sex when they receive what they really want. I’ve heard of some mythological women who actually want sex for themselves, but men aren’t expected to hold their genitals for a ransom before providing sex.

I also have some suspicion that some men want more from women than a hot meal and a sexual favor, but women aren’t expected to show men affection and care just as a means to get in their pants.

Nonetheless, I do celebrate Valentine’s Day, and I think I always have. Perhaps I am just a victim of social programming, or maybe I’ve tried, with limited success, to create a holiday for a genuine and equal sharing of love, affection, and small gifts. I’m not sure whether it is possible to rise above the reductionistic stereotypes that infuse us from birth, but Valentine’s Day gives us a little more wiggle room than Steak and BJ Day. It is impossible to say the name of Steak and BJ Day without invoking crude masculine stereotypes. However, we can create our own Valentine’s Day, or at least pretend to, so let’s share equally, love equally, and make a better world.

Happy Valentine’s Day.

Seeking God in Silence

R. Horton

Painter Fang Min has a series of paintings featuring Buddhist monks seeming happy enough despite an insect perched on or near their faces (you can see examples here and here). When I saw the exhibit in China, a small explanation accompanied the paintings. I Monks jdon’t remember it in detail, and I can’t seem to find it anywhere online, but the story was fairly straightforward. It was about a monk who left the hustle bustle of the city to see peace and tranquility in the country only to find that his meditations were still disturbed by the sounds of the country: farmers working, livestock making noises, and so on. He retreated further away, deep into the woods, but still found the sounds of nature disturbing. Eventually, he fled deep inside a cave to find absolute quiet—except for the sound of a single insect. Frustrated that he still was unable to secure tranquility, he sought out the Buddha for advice. The Buddha told him, of course, that he must seek tranquility inside himself, not demand it from the world around him.

This reminded me of my experiences with the Religious Society of Friends (or Quakers). The meetings I attended were unprogrammed, which means Friends sit in silent reflection receptive to spiritual prompting. Some people refer to this as “silent worship” or a “silent meeting.” This isn’t really accurate, as Friends are expected to speak when moved to do so. Nonetheless, some people would remark on how wonderful some meetings were when they remained especially quiet. On other occasions, some attendees would complain of being distracted by the sounds of people speaking, children, animals, neighbors mowing lawns, airplanes passing overhead, and on and on.

I always thought that if I were to sit in silent reflection, it meant that I would not make any noise, not that I wouldn’t hear any. If I understand correctly, Quakers have the idea that God is in everything and everyone. For me, listening for God is just to listen to whatever happens to be in the universe. I never took it that God could distract me from God. The work is in the contemplation I am doing, not in finding silence.

The composer John Cage said that music never stops, only listening does. To help people listen, he composed a piece that was four minutes and 33 seconds of silence. During that piece, the audience listened to ambient sounds in the environment (or even the sounds of their own bodies). Cage said that anyone can do this at any time. It just takes an aesthetic attitude. He wasn’t trying to create four and a half minutes of silence. He was trying to create four and a half minutes of attention. Some people did not like being forced into a meditative state, but some people don’t like anything.

I suppose some of this depends on what one seeks when one seeks God. Spinoza described God as being infinite and eternal. God occupies every point in space and every moment in time. What then, is not God? Everything in the universe must be God, and God must be everything in the universe. To believe anything else is to limit God’s presence and power. I think this is why Einstein said he believed in the God of Spinoza.

Everything you hear today is the voice of God. Everything you see is the presence of God. Keep your eyes and ears open, please.