The ethics and rights debate in the helping professions

Most people in the helping professions will be aware of the proposal to have counsellors and psychotherapists appropriately trained and registered. On the surface this sounds like a good idea. Currently just about anyone can call themselves a counsellor or psychotherapist.

This can be good and bad. On the one hand it provides the public with a wide variety of options but it also means a lot of poor operators go unregulated and unconstrained.

So far people like me have relied on the fact that we can demonstrate our qualifications and experience and we build reputations on good practice. However, very gradually, over the past few years governing bodies have been established and they have been calling for memberships and developing registries with the aim of weeding out the perceived unsuitable operators and giving legitimacy to the profession.

These organisations generally provide membership along three main categories: those who are interested in the helping professions (they need to demonstrate why they are interested); those who are working in the field but are not clinical workers; and those who claim the status of clinical practitioners. Membership ranges from $100 to $200+ per year.

What do members get for their money? They get opinion, reviews, advertising in a newsletter, and networking. They are also kept informed and are given the opportunity to participate in the required ongoing professional development. This is where the real money changes hands. In order to legitimately maintain one’s professional practice, one must engage in ongoing professional development and gain a number of points over the year. This usually happens in one or two-day workshops and it can cost the professional hundreds and thousands of dollars. It is big business!

The overall aim for the professional then must be to grow their practice to meet the costs but does this benefit their clients? Fast capitalism may not be viewed as best practice or conducive to the rights of the client but this in turn is offset by imposing a voluntary system of ethics. It begs the question; can one be ethical in a system of free markets? In my view the “ethics” discourse serves to undermine the “rights” discourse. It leads people to believe they are protected from malpractice when they are not.

Ethics: theory and practice

Given that a counsellor can now get a job after completing a one-term TAFE course (or a one-year postgraduate diploma from a university if they want to supervise) it stands to reason that ethics is not going to be given the attention it deserves. What is usually taught is a system of rules and mandates but the issues involved are not always clear cut and unequivocal. Ethics has its origins in philosophy. It is a complex and precise discipline that cannot be conveyed through crash courses and minimum standards. People who call themselves ethicists are people who solve problems at the highest level of intellectual analysis. They are also governed by certain principles.

I will begin by describing the two schools of thought in modern philosophy as they might relate to the current debate in ethics. One school of thought takes the Marxist and Hegelian view that humans are intrinsically good and the system corrupts them. The other comes from the Freud where the view is that humans are driven by the deep, dark forces of the unconscious desires and fantasies. Humans are therefore inherently bad (the primal horde) and need to be tamed.

The evolutionary view of benevolence/altruism/ethics is that it is underscored by human interests. Or put differently, the instincts of survival. This does not preclude attempts at best practice. A universal system of ethics is necessary for a universal system of law and the reverse is also true, but neither can stand alone. Without effective laws - and the material means for ordinary people to access the judicial system - a discourse of ethics is meaningless.

Narratives of ethics, compliance and law

Modern counselling and psychotherapy draws on an old idea. It was the 18th century public sphere that gave birth to the therapist and narrative as a means of a cure for all the social ills. Freud (1929) was the main pioneer. Control of the primal horde through narrative/counselling/analysis is an old methodology: it didn’t work before I don’t expect it to work now. Language does not travel in a direct line from A to B. Language has language frames, schemata, and conceptual views. Further, the narrative discourse assumes that all people can become rational and exchange ideas, I do not hold to this view.

The revitalisation of the public sphere and “talk” as a means of curing the social malaise is both enabling and constraining. Dialogue as an integral component of democracy was given credence by the world renowned philosopher and social theorist Jurgen Habermas in his Theory of Communicative Action (1987). Therapeutic practices were viewed as being democratic and a way of levelling the power relations between the therapist and client. While Habermas was very careful to separate himself from the post-structuralist/postmodernist transcendent discourses, the “helping professions” have taken these depoliticised discourses on board. This means power is carried through discursive means ipso facto into forms of management counselling as opposed to counselling for social change. This mode of counselling serves the hegemonic forces of neo-liberalism not the interests of the client. I do not regard this as best practice.

It was Kant in his Aesthetic Judgement who devised the 18th century public sphere and Kant who alerted us to the aesthetic (imaginative) nature of capitalism. What this means is almost everything is marketable. Counselling is marketable and an “ethics” discourse is also equally marketable. Markets are malleable. The question remains; can we rote learn a system of ethical rules and make our practices inherently ethical? Can we be ethical in a system that is fundamentally and ethically flawed?

Ethics: antecedents in ethics philosophy

As a general rule, ethical counselling holds that the welfare of the client is paramount along with autonomy. I contend that if the efficacy of counselling is going to be based upon the premise of ethical practice then surely it is the roots of ethical philosophy that need to be explored before particular issues of ethics in counselling can be adequately addressed.

It should come as no surprise to the politically adept that a civil society does not promote knowledge of its hegemonic powers. Or that such a civil society almost certainly engages in creating the very problems it is aiming to solve. It is not the first time a civil society has been caught out manifesting such problems and their remedies. The previous case relates to the 18th century Enlightenment that was involved in the same issues of power it was purported to eliminate.

As things stand, no one is going to do anything to eliminate the social consequences of neo-liberalism, least of all the non-politicised counsellor. Yet, it might be worth considering that by invoking more conceptual approaches to “ethics in counselling” the would-be counsellor might be in a better position to help their clients understand the workings of an unjust and inequitable world. A counsellor might even be motivated to act towards changing it, rather than becoming its manager.

Depoliticised discourses

There cannot be “autonomy” without politicisation because personal empowerment is contingent upon the understanding of the inherent power relations (politics is power). This is not to throw dispersions on well meaning counsellors. Rather, to alert them to the existence of false consciousness. The “Third Way” transcendent and depoliticised discourses - where working through conflicts gives way to processes of mediation - are usually a compromise at the expense of the powerless.

Mediation treats all conflict as negative when a lot has been learned via conflict, including the body of knowledge we now call ethics.

This leads to a further question: why have we embarked upon a discourse of ethics and not a discourse of rights? It is evident that the current ethics discourse serves to undermine the rights discourse. No one asks: why do we need an ethics discourse? What is so wrong with society that we do not have universal justice? Why is it that most individuals cannot be empowered to have happy fulfilling lives? These are the political questions that need to be asked before we embark on any system of ethics. The fundamentals need to be fully understood. There are no ethics without enlightenment.

Ethics: from Plato to utilitarianism

Ethics is a branch of philosophy that borrows heavily from Plato’s Republic and Aristotle’s Ethics. Plato’s Republic can hardly be described as best (ethical) practice. It advocates the view that some men are born to rule and others are born to follow.

In Plato’s view you are only deserving of “ethical” treatment if you are a citizen not a slave.

We have not shifted too far from this view. Plato viewed ethics as so strongly embedded in the social nature of man that he decided to investigate it through the characteristics of a good state, but this wasn’t a real state, it was a figment of Plato’s imagination; a fantasy. Hitherto, all those who have followed the Platonic path have built their dreams and aspirations on delusion.

In modern psychiatric terms, we might think about it as a psychosis. We have to wonder then about the virtues of ethical decisions that are still largely grounded in the Platonic moral legacy.

Ethical philosophy has “occurred throughout a history of speculative thought”. Indeed, ethics was born out of a conglomeration of conflicting ideas: “Heraclitus and Democritus, Antisthenes and Aristippus, Zeno and Epicurus, Descartes and Gassendi, Cudworth and Hobbes, Reid and Hume, Kant and Bentham”. During the period referred to as the 18th century Enlightenment Descartes and Kant posited ideas on ideal ethical behaviour. Johns Stuart Mills, Adam Smith, Herbert Spencer and others attempted to ground the abstract idealism into a concrete body of ideas called utilitarianism.

Today, utilitarianism is still a common branch of ethics and philosophy, which, I contend is significantly flawed.

Utilitarianism lends its theory to the branch of ethics that has been called consequentialism. In this idea “the classical utilitarian regards an action as right if it produces as much or more of an increase in the happiness of all affected by it than any alternative action, and wrong if it doesn’t”.

There are numerous problems with this idea but the major one stems originally from Marx’s critique of Hegel where he demonstrated by exploring capitalism that the focus on “goals” does not account for the present, which all too often includes such things as poverty, misery and desperation. Further, consequentialism does not account for the nature of false consciousness.

In today’s, terms we might refer to this as the influences of the media. Utilitarianism underwrites neo-liberalism replete with its own meta-narratives and concomitant contradictions. Ethics is distinctly Eurocentric and probably totally out of place in a multicultural society. A number of “ethical” dilemmas are likely to be irreconcilable unless they are enforced by laws.

Utilitarianism is sometimes referred to in philosophy as “Duty, Happiness, Perfection”; or “THE RIGHT AND THE GOOD”… a moral law that states something “ought to be”. Importantly, any ethical system based upon this philosophy is couched in abstract idealism and transcends the setting in which the issues occur - it loses touch with reality - and imposes a romantic/transcendent solution.

It could be argued that a modern system of Ethics for the Helping Professions aims to take a more holistic approach, one that gives focus to a rights-based ethical practice. However, a jurist might ask what kind of system of rights (or ethics) do we have if we cannot enforce it in court? Hence, ethics does not placate the problems of society or the individual it creates an “ideal type”.

There are undoubtedly people who experience immense pain in the here and now. What would one put in place of current counselling and psychotherapeutic practices to help these people? Masson suggests self-help groups that are leaderless and no money is exchanged. Another option is the exploration of the arts. This is happening with some consciously diverse people through Brut Art but it is experimental and limited. The bottom line is when there are no power relations it is almost impossible for people to act unethically.

The major problem with this idea

In a society truly focused on civil liberty where everyone has protection under the law can we say we have no need for ethical or moral principles? The anarchist Sorokin (1957) argued that “the best source of ‘social mirror’ of the ethical mentality and respective forms of conduct, or the mores is usually given by the totality of the ‘official’ laws of a given group, plus its moral prescriptions”.

For Sorokin the ethical mentality was also the most authoritarian. Following this theory it would appear that having eliminated the core of the authoritarian welfare state we have simply substituted one authoritarian system for another and a more discursive means of controlling behaviour through organisations that resemble those of the 18th century guilds. These guilds acted as a form of protectionism for the professional elite.

It is now estimated that one in five people in Australia suffer from depression, this is surely the most pressing ethical dilemma for the helping professions and it requires political and social change not philosophical and ethical deliberation.