"Soul Searching: Why Psychotherapy Must Promote Moral Responsibility" by William Doherty

Kindle edition.

• "pushing me to be  more courageous at times when I was waffling"
• "psychotherapy in America is facing a crisis of public confidence"
• "the crisis is over psychotherapy's ability to  speak to the profound social and moral problems of our day"
• "Are  therapists making these problems worse by justifying the contemporary   flight from personal responsibility, moral accountability,  and participatory community?"
• "Two of the most prominent philosophers in the world,  Alasdair Maclntyre and Jurgen Habermas, have each raised concerns   about the impact of the "therapeutic culture" on contemporary   mores and morality. Both implicate psychotherapy in the  decline of family and community in the Western world."
• "moral lobotomy"
• "This book argues that therapists since the time of Freud have overemphasized individual self-interest"
• "cultivation   in therapists of the virtues and skills needed to be moral consultants
   to their clients in a pluralistic and morally opaque world"
• "therapists' failure to attend to the broader moral and  community dimension has left psychotherapy vulnerable to being  managed as just one more commodity in the health care marketplace"
• "Morally sterilized psychotherapy has lost whatever moral  leverage it could have used against the hegemony of the bottom-line   economic decision making practiced by many public officials  and managers of health care."
• "1985 in Habits of the Heart by Robert Bellah,  Richard Madsen, William Sullivan, Ann Swidler, and Steven Tipton ... In expressive individualism,   the same logic holds for emotional well-being: we can each  focus on ourselves because personal psychological well-being  inevitably leads to family and community well-being."
• "responsibilities to others are reduced to responsibility to self"
• "Rieff  posited that four "character ideals" have successively dominated  Western civilization: (1) the Political Man of classical antiquity (I  retain Rieff's prefeminist language); (2) the Religious Man (Judaism  and Christianity until the Enlightenment); (3) the Economic Man  (Enlightenment through the early twentieth century); and now (4)  the Psychological Man, whose goal is self-satisfaction and personal  insight in order to master "the last enemy-his personality."
• "the psychotherapist becomes  the de facto moral teacher in contemporary American society"
• "The result has been a reflexive morality of individual  self-fulfillment, with relational and community commitments seen  as means to the end of personal well-being, to be maintained as  long as they work for us and discarded when they do not."
• "For each of us there is the  opportunity to emerge reborn, authentically unique, with an  enlarged capacity to love ourselves and embrace others.... The  delights of self-discovery are always available. Though loved ones  move in and out of our lives, the capacity to love remains."
• "I have seen too many parents "move on" from their  children, too many spouses discard a marriage when an attractive  alternative appeared, and too many individuals avoiding social  responsibility under the rubric of "it's not my thing."
• "But there are many progressive  voices of reevaluation, those who appreciate what the ideals of personal   freedom and the pursuit of happiness have contributed to  the modern world and who see the struggle for freedom and  equality as unfinished, who nevertheless believe that the mainstream American cultural values of private gain (both economic  and psychological) and communitarian values and responsibilities  are badly out of balance."
• "By the 1990s, however, whatever has served as the moral center  of mainstream culture seems not to be holding. Massive cheating  in the business world and in military academies, unprecedented  levels of crime and violence, shocking reports of physical and sexual   abuse in families, widespread abandonment of children by  divorced as well as never-married fathers, followed by justifications   based on personal entitlement, doing one's own thing, or victimization-these   are examples of trends that undermine any  concern that contemporary Americans have overlearned a rigidly conventional morality that they must be liberated from by an army  of psychotherapists."
• "We in America have become a society devoted to the individual  self. The danger is that psychotherapy becomes a self-concern, fitting   ... a new kind of client ... the narcissistic personality...."
• "Rarely does one speak of duty to one's society-almost everyone  undergoing therapy is concerned with individual gain, and the  psychotherapist is hired to assist in this endeavor."
• "not a therapy   that turns them inward to the exclusion of their interpersonal  commitments, but a therapy that honors their sense of relational  responsibility while helping them to manage both parts of the  Golden Rule: Love others as you love yourself"
• "powerful   critiques by psychologists of psychology's role as a perpetrator   of selfish individualism and social control by intellectual  elites."
• "From a variety of quarters, the field of psychotherapy is taking a new  look at itself"take a step beyond critique into reenvisioning  psychotherapy as a moral enterprise"
• "the heart of therapy-the therapeutic conversation   in which shared realities are created and healing occurs"
• "I am more  interested in raising issues than in settling them."
• "Why is it that when public officials use the term "moral responsibility" they are generally  talking about families on one kind of public assistance and not  corporations on another kind of public assistance called tax  breaks?"
• "three core therapist  virtues: caring, courage, and prudence"
• "Caring is the quality that allows them to connect with  clients; courage allows them to take risks and face difficult questions;   prudence helps them make good decisions in the face of  uncertainty."
• "I do not want to yield the moral terrain to  those who know too well how others should behave."
• "It has been said that the two major errors in moral philosophy are  thinking you know all the truth and thinking that there is no truth  to be known."
• "Therapists help clients to better  understand themselves and other people and to he good to themselves   and other people"
• "Not wanting to impose their moral standards, they  avoid the topic altogether."
• "Psychotherapy at its best, however, can be a profoundly humanizing   experience that increases our moral capacity."
• "To engage in moral consultation, therapists do not have to dictate   moral rules or claim to have all the answers."
• "as Alan  Wolfe described the role of the social scientist dealing with morality,   the therapist's role is to try "to locate a sense of moral obligation   in common sense, ordinary emotions, and everyday life ... to  help individuals discover and apply for themselves the moral rules  they already, as social beings, possess."
• "I  try to show in this book that psychotherapy has the resources to  contribute to the formation of a new cultural ideal in which personal   fulfillment will be seen as part of a seamless web of interpersonal   and community bonds that nurture us and create obligations  we cannot ignore and still be human."
• "HERE IS AN OPEN SECRET AMONG THERAPISTS, ONE WE  don't talk about much and certainly don't write about.  Despite our intense rivalries and debates about models and techniques   of therapy-psychodynamic versus cognitive-behavioral  versus family systems versus a hundred other variations-when it  comes to referring a family member or close friend to a therapist,  we think first of the kind of person the therapist is."

Caring

• "Will the  therapist care? These questions revolve around the personal qualities"
• "caring, courage,  and prudence. These three qualities of character do not, of course, exhaust  the range of virtues required to be a good therapist"
• "it takes more than knowledge and skill to be a  good therapist. It takes certain qualities of character, or what the  Greeks called "virtues." Virtue can be defined as a predisposition  to do what is good or right."
• "Granted, we all have the obligation to be decent human  beings-to be truthful and honest and loyal, for example-but  what are the special qualities therapists must have in abundance to  do their job well? What are the virtues that therapists must develop  to a higher degree than, say, engineers or lawyers?"
• "a virtue-based professional ethic must be closely  linked to the nature of the profession itself"
• "Pellegrino and  Thomasma maintain that "the moral essence of a health profession   is the special relationship that sickness and the response to illness   creates between healer and patient...."
• "A central virtue for therapists, then, as well as for other health  professionals, is the ability and predisposition to care for those who  entrust their pain to us."
• "Perhaps even more than in other health  care settings, the caring bond therapists offer to clients is the heart  of the process and the central vehicle for our effectiveness."
• "the therapist's ability to create a warm,  accepting atmosphere is a principal healing component in all  forms of psychotherapy. Its absence is a primary cause of therapeutic failure."
• "Caring, then, is the cornerstone virtue for therapists."
• "Viktor Frankl, the famous psychotherapist   and founder of logotherapy, shows how caring supersedes  the techniques we often believe are the curative factor in treatment."
• "The only reason she had  decided not to commit suicide was the fact that, rather than growing   angry because of having been disturbed in my sleep in the middle   of the night, I had patiently listened to her and talked with her  for half an hour, and a world - she found - in which this can happen,   must be a world worth living in."
• "Although therapists sometimes take their care for granted, clients do not. They know the real thing when they feel it come their way."
• "Therapists, like physicians  and lawyers, are more comfortable with the language of techniques   than with the language of morality, with skills-talk more  than virtues-talk."
• "psychologist Seymour Sarason claims that the major "helping"   professions in the United States (medicine, psychology, teaching,   and law) have systematically deemphasized the role of caring  and compassion.' This deemphasis reflects a larger cultural lionizing   of rationality and technology in American life. After all, isn't it  better to be hard-nosed than softheaded?"
• "Sarason  also believes that caring and compassion have become casualties of  American individualism, because clients who are stripped of their  social context are more likely to be seen as categories-as their disease,   their IQ, their legal status."
• "They are known people with a known social  context; they cannot be summed up by their current physical state."
• "Caring, then, is not just a frill in the helping professions. It is an  essential lubricant for the flow of mutual understanding, which is, after all, the heart of a helping relationship."
• "The one-caring is letting the  other in, feeling with the other rather than just figuring out the  other."
• "For therapists, the difference is between knowing that  someone is depressed and also being able to be with this person  emotionally in the experience of sadness and despair."the one-caring is saying, with his or  her attentiveness, "You are the total focus of my concern right  now. There is nothing to distract me from attending to you." For  clients in psychotherapy, experiencing this engrossed concern and  attention from the therapist brings a powerful sense of being important, accepted, affirmed, and even loved."
• "The  therapist must have a solid sense of self in order to maintain personal   and professional boundaries and to keep a dual focus on the  client's experience and his or her own internal experience. We  must become engrossed in our clients' experience without losing  ourselves there."
• "willingness   to assist with the other's agenda rather than promoting your  own"
• "When the client's goals or expectations   do not match with our professional or personal agendas, it  can be difficult to maintain a caring relation."
• "Natural caring comes most easily when the client is similar  to the therapist in some way, shows pain directly, asks for help,  and responds appreciatively when the therapist offers it."
• "Whereas natural caring involves the ability to respond spontaneously   to those who entrust their pain to us, "ethical caring" takes  over when spontaneous sentiments are not available to help make a  caring connection."
• "We have all encountered clients who turn us off personally. The  biggest turnoff for most therapists, I believe, is the client who  denies personal responsibility for problems, who expects the therapist   to fix things, and who is never satisfied with the therapist's  performance."
• "Most of us know that we cannot help someone we  don't care for, and that we cannot care unless we find something in  the person's pain or joy to respond to."
• "he was a novice to feelings-talk but wanted to save his marriage"
• "I could both  empower her and challenge her because I had found a way to care."
• "ethical caring keeps me  afloat like a life preserver until my natural buoyancy reemerges."
• "The barriers to the virtue of caring come in several forms. For  starters, there are clients for whom ethical caring never leads to  natural caring."
• "In my own experience with barriers to caring, I tend to stubbornly   hold on, trying to find an opening for caring."
• "All  clients deserve a therapist who can give them both ethical and natural caring."
• "In addition to the barriers that clients bring to the caring relationship   and the ones therapists bring, both idiosyncratic and  developmental, there are harriers built into the medical model of  diagnosis and treatment that most therapists learn and practice.  We learn to use labels that, if we are not careful, can objectify our  clients."
• "useful to know if  the client is clinically depressed or schizophrenic, or if the relationship   is abusive. The danger comes from the tendency of the clinical   label to become so figural that the client's personal context  becomes invisible. We end up describing and relating to the person   as a problem, a deficit, a category, instead of as a complex  human being with a problem."
• "Wendy is a borderline" is an apparently   neutral statement that carries with it the danger of objectifying   Wendy as a personality disorder"
• "We think we are describing the client when actually we are saying  more about our own feelings. When we have a problem caring for  a client, we make it the client's problem instead of our own."
• "Clinical techniques are the great double-edged sword of psychotherapy.  They are the vehicle for delivering therapy, but they  can also be a haven for a heartless therapist."
• "The danger  occurs when we use a technique without sensitive regard for the  needs and goals of the client."
• "Therapy trainers   have a responsibility to the next generation to not be silent  about the centrality of caring in the practice of their profession."
• "Paradoxical techniques  are strategies such as urging the client to continue to enact a symptom,   such as asking someone who worries too much to schedule  time each day to worry, thereby deliberately controlling something  that seemed uncontrollable."
• "At their worst, therapists can  sound no different from the overworked and frustrated medical  residents"
• "these  feelings are something to be worked through, not projected onto  our clients"
• "Unsupportive and alienating work settings inevitably  affect therapists' ability to care, especially for difficult clients at the  end of a long workday or workweek."
• "Barriers to care show themselves particularly with clients from  cultures or social class groups different from our own or from  groups whose members are not represented well on the clinical  staff."
• "If caring is based on developing understanding, it is tested  every time we work with people with whom we do not share a life  world."
• "confusion about caring and confronting,   the notion that caring always means being supportive  and accepting."
• "toughness of caring"
• "Truly taking on the goals of the client means that sometimes I  must be forceful and even provocative."
• "It is not enough for therapists to believe they are caring; clients  must feel it."
• "The small things show nonscripted care"
• "Truly  caring for someone means caring about those they love and have  some responsibility for."
• "the therapeutic   ethic of individualistic self-interest can block understanding  and caring for a client who feels moral responsibility for a loved  one's welfare."
• "sensitivity  to social context is essential to understanding and compassion in  professional relationships."
• "The morally caring therapist is prepared to  automatically treat the client with sensitivity and respect, whether  onstage in the therapy session or offstage"
• "Therapists, of course, cannot help everyone achieve their goals. If therapists cannot  always promise change, let alone miracles, we can promise to walk  with people who entrust themselves to us, to support and challenge   them, and to never objectify them or exploit them for our  own purposes."

Courage

• "Courage has gotten poor press in recent years."
• "I want to reclaim the virtue of courage because, simply  put, it takes courage to he a good therapist. The best therapists  invariably have a goodly supply of it."
• "Courage is a virtue practiced in the present moment but only  thought about consciously after the brave deed is completed."
• "the subjective   experience of courage itself: it demands absorption in the challenging   situation, with a minimum of self-consciousness about the  extraordinary nature of one's acts"
• "virtue of courage, which  the Merriam-Webster Dictionary defines as "the firmness of spirit  that faces danger or extreme difficulty without flinching or  retreating." ' "
• "He was asking me to change her, not to help  him manage his part better."
• "Therapists have colleagues to turn  to for help in sorting out the intricacies of clinical relationships; physicians generally have nowhere to turn for this kind of perspective.
• "I had made an exception to the guidelines I teach my  students about staying out of triangles and not doing people's  work for them."
• "I felt very vulnerable,   as if I had lit a fuse whose path I could not foresee."
• "When my worst fears are laid out before me this starkly, like  many people I often find myself becoming calm and resolute."
• "You may get fired by the clients for this," he had  said, "but you did the right thing."
• "in retrospect, I do believe  that this case called upon my deepest reserves of self-confidence  and determination and on my willingness to take emotional and  professional risks for the welfare of my clients. It was an opportunity   to practice the virtue of courage"
• "David Waters and Edith Lawrence are among the very few therapists   who have written about courage. In their insightful book  Competence, Courage, and Change"
• "Courage, they believe, is what gets clients past blocks to their  development and what empowers therapists to persevere in difficult   clinical situations."
• "Therapists experience the courage to keep  caring, the courage to keep trying, and the courage to take clear  stands."
• "failures of courage, according to Waters  and Lawrence, are most often evinced when therapists allow  clients to stay with old patterns instead of moving the therapy to a  new level of intensity that might be challenging for the therapist"
• "therapists   without courage ultimately lack the wherewithal to help  clients with difficult problems, especially when those clients tax  the clinical relationship"
• "Therapy, after all, is a world of  feelings and introspection and vulnerability, a world that is  often alien to the traditional culture of masculinity."
• "In some cases, I believe the marriage is a casualty of the  therapist's limited courage."
• "The main problem here is not that some therapists have difficulty   working with these men (we all have clients we have trouble  working with), but that they see the obstacle as lying in their  potential clients rather than in themselves."
• "As a result, they make  clinical recommendations designed to treat their own anxiety  rather than the client's problems."
• "I  borrowed a line from my colleague Noel Larson when I told Bill that I didn't think he was in the right frame of mind to make such  a big decision. I noted that he clearly had made suicide an option  again for himself and that I respected his right to decide his own  fate. But I could not accept a decision made when he was so out of  sorts."
• "The moment of courage  (again, retrospectively) was my willingness to not pull the plug on  his right to make his own decision about living or dying."
• "A quality is a virtue only if it is hard to practice consistently."
• "Every  virtue has two negative sides: the tendency to exaggerate it and the  tendency to underplay it."
• "facing ourselves honestly might be the essential form of courage for psychotherapists,  because that is what we are asking our clients to do"
• "The dangerous   therapists are not the ones who recognize and feel badly about  their failure to take an appropriate risk, but the ones who rationalize   their lapses or put the responsibility on the clients."
• "Recognizing and confronting our own emotional reactions to  our clients-termed countertransference in psychodynamic  therapy-is a special form of courage required of therapists  more than of any other group of professionals."
• "of all the helping professions, we have arguably the most  intense relationships with our clients"
• "therapists are called to be brave about their inner  lives as they affect the practice of therapy"
• "Failure of nerve in  this area is bound to harm our clients because we will not be able  to really see and understand them through the invisible veil of  our distortions."
• "Looking steadily at ourselves in the mirror, then, is the special  form of therapeutic courage that enables us to take risks with  clients."
• "Many failures of nerve by therapists  can be traced back to flinching from self-awareness."
• "Therapists are people who like to be close to others and important  to them; that's partly why we go into this business."
•  "the best therapists are  also brave enough to make clients uncomfortable at times and to  risk therapeutic closeness by plunging into murky waters"
• "extraordinarily challenging moments for therapists, especially in  the current litigious climate"
• "When therapists reach the point - and many have - where advocacy for clients seems self-destructive,  then psychotherapy as a  healing profession is seriously compromised."
• "when is the risk too great to take on behalf of a  client?"
• "Each profession has  special qualities of courage required of it. Ours is work of the  heart, for which we need regular transfusions of support and challenge from our close colleagues."
• "organized  action to preserve the ethical integrity of psychotherapy in a world  where market forces and government regulation increasingly sterilize   this healing art and where therapists' own collusion has contributed   mightily to the problem."
• "Firmness of spirit is an acquired virtue that as therapists   we are called to embrace and cultivate throughout our  careers, for the good of our clients and the community, and for the  enrichment of our own humanity."

Prudence

• "Courage without  prudence leads to danger and death, caring without prudence leads  to invasions of autonomy, truthfulness without prudence leads to  tactless hurts, and community service without prudence leads to  neglect of one's personal world."
• "A mark of a very good therapist is the ability  to consistently make the right move at the right time."
• "Prudence rightly understood is not about being cautious  but about being wise."
• "I could help  them split up constructively or I could help them try to salvage  their marriage, but I needed each of them to vote on which option  they wanted me to work with them on."
• "I pushed ahead vigorously when I should have stayed with her in  her ambivalence."
• "Ben Hunt, who said during a lecture, "When we  learn something new, it is almost impossible not to absolutize it in  some way." A new truth tends to fill the firmament for a time,  blocking out older truths."
• "The practical implication for therapists  is that we may be most at risk for lapses in judgment when we  have learned a sparkling new insight."
• "sensitivity to the unique needs of the client  and respect for her autonomy in making a decision only when she  was ready"
• "I have seen therapists make some of their worst clinical mistakes
   after returning from a workshop with a master therapist  who has well-edited clinical tapes that demonstrate marvelous  new techniques."
• "Perhaps clients should be given fair warning when  therapists embrace a new diagnosis or treatment technique: your  therapist has learned something new and may act strangely today."
• "therapists are being roundly criticized,   even ridiculed in cartoons such as "Doonesbury," for leaving  their prudence at home when they go to the office.'
• "This new learning, coupled with collective guilt for past ignorance, creates a fertile soil for shaky judgment."
• "What is most important, from this perspective,   is to stay connected with the feelings of the client"
• "good judgment by a professional therapist requires the ability to  think epidemiologically"
• "If 80 percent of life is showing up, most of the rest is timing."
• "A  sense of timing is the hallmark of the prudent therapist."
• "Prudence is also  reflected in the ability to accept the limits of the changes that can  be achieved in psychotherapy."
• "I had learned that commitment is the cornerstone  of a marriage; without it, there is nothing to work with."
• "his problem with ambivalence   about commitment was one that he had struggled with but  was apparently unable to overcome at this point. He had learned  that the issue wasn't about his relationship with Mary in particular  but about commitment to any woman. Since he might remain  ambivalent all his life, the question for Dick to ponder was  whether Mary was the woman he wanted to be ambivalent with."
• "His  ambivalence was like a chronic knee problem that would hamper  him somewhat in any sport he played. Why not play the sport he loved?"
• "the wisdom of  accepting what cannot he changed, without a sense of tragedy or  failure"
• "live graciously with problems that don't go away"
• "the  importance of maintaining commitments to "good-enough" relationships   that carry history and roots and responsibilities instead of  discarding them in the quest for the holy grail of the perfect relationship"
• "What I did was offer a way  to frame their difficulty that left them each an opening to maintain   their satisfactory marriage without selling out their needs and  integrity as individuals."
• "Therapists have enormous influence through the way they frame  questions and make observations with clients."
• "at those bracketed moments of moral intensity in people's   lives, we have the power to help and harm in equal measure"

• "What do you need to do for yourself right now to  get through this?"
• "children were not  responsible for the marital breakup, and that it simply was not fair  to make them its casualties"
• "I had been socialized into a therapy  profession that by the 1970s had developed the firm conviction  that "shoulds" entrap people into living life for someone else. The  only authentic life was based on heeding the dictates of "I want."'"
• "Many family  therapists are comfortable talking about what clients need and  deserve from other family members but are very reluctant to talk  about what clients owe other family members in care, commitment,  fairness, and honesty."
• "In dealing with moral decisions, however,   I think it is generally a mistake to appeal only to a client's  self-interest, even if that appeal "works," because the ethic of personal
   gain we thus promote erodes the quality of our clients' lives  and ultimately the quality of community life."
• "Expanding the therapeutic conversation beyond the client's self-interest,   however, pushes most therapists beyond their training and  beyond the resources available in most psychotherapy literature."
• "Being concerned with clients' immediate needs is certainly not an  invalid therapeutic concern, but when that becomes our only consideration,   therapy lacks moral and human depth and therapists  end up promoting trickle-down psychological economics."
• "psychotherapy lacks a conscious moral tradition"
• "it is crucial for therapists to distinguish  between personal values and moral convictions"
• "Emotional intimacy, based on  mutual self-disclosure"
• "I consider commitment the moral linchpin of family relationships. It is more than a private, idiosyncratic value"
• "family commitment as  "covenant"-unbreakable, unilateral, unbrokered parental investment"
• "an economic  and contractual way of thinking about relationships that was confounding   his moral sensibilities"
• "the parental version   of a nuclear weapon - abandonment"
• "Psychological language tends to be long on explanations and  short on responsibility."
• "Sometimes it is necessary to do the right thing before understanding why we have been doing the wrong thing."
• "From a moral point of view, he did not have the  luxury of delaying change until he had achieved more insight,  higher self-esteem, or better emotional resolution of his divorce."
• "When I encourage or challenge a client in the moral realm, I do it  with full compassion for the powerful personal binds that can  lead us all to compromise our moral beliefs, along with a sense of  appropriate timing about when to listen and support, when to  raise questions, and when to challenge."
• "the moral fabric of a family had been resewn with a stronger  thread of commitment"
• "acknowledgment and affirmation of the client's moral language  and moral sensibilities"
• ""That's an important question. What kinds of things are you doing that you think  might be unfair to your husband?"
• ""What is she to you now?" This is a classic  illustration of egocentric therapeutic morality at work: every expression of obligation is unhealthy until proven otherwise, and every relationship should be measured by its current rewards and  costs."
• "The reining clinical assumption about couples  considering divorce might be expressed as follows: Is each partner  getting back enough for what he or she is putting into it?"
• "In her book Uncoupling, the sociologist Diane Vaughan  describes how clients sometimes use therapists as "transition figures" to make an exit from a marriage, particularly when they are  in individual therapy."
• "self-interest is a valid and even necessary component of a marital commitment decision. My concern is that  self-interest is often the only language accepted in therapy when  an individual is making the fateful decision about ending a marriage"
• "the  power of moral commitment in sustaining a troubled marriage"
• "After the third or fourth major relapse during the first year of  therapy, I told them that I was running out of ideas about how to  help them and asked if they wanted to continue to see me."
• "working on their ability to identify their needs, negotiate   openly and fairly, and keep the children out of their problems"
• "they  regard their relationship as a "good-enough" marriage, one  grounded in their commitment to each other and their children  and in their mutual determination to make it work even if it is not  the marriage they had hoped for in their youth"
• "As therapists, we are moral consultants, not just psychosocial  consultants. We should not try to impose our beliefs on undecided  clients, but we can advocate in an open manner when appropriate."
• "Provided there is no abuse or intimidation, in most cases I tell  clients who are considering divorce that I will help them look at  their situation and make their own decision, but that I will he  leaning toward seeing if it is possible to restore the viability of the  marriage."
• "I look for areas of  strength, sniffing for the presence of hope in the midst of pessimism,   listening for clues for change. If clients ultimately decide  on a divorce, I accept their decision and, if they have children, move on to discuss how they can maintain their commitment as  coparents to their children."
• "I support the value of marital  commitment, a moral issue about which I am not neutral, in the  context of respect for clients as moral agents of their own lives."
• "commitment means more than the willingness to stay married"
• "Divorce, I have  come to believe, is like an amputation: to be prevented and  avoided with all vigor and persistence, but to be done cleanly and  decisively when all efforts to keep the body intact have been  exhausted."
• "I believe that it is irresponsible to end a marriage   without attempting marital therapy to see if it can be  restored to health-just as it is considered irresponsible to let a  loved one die without seeking medical help."
• "whose morality should be introduced. Who decides what is right and  wrong in any given situation?"
• "When is a divorce an  escape from one's adult responsibilities and when is it a necessary,  though sometimes tragic, act of moral courage?"
• "When is placing  an elderly parent in a nursing home an act of abandonment and  when is it an act of responsibility?"
• "Morality emerges for all of us from social interaction   punctuated by moments of personal reflection. Morality, in  the words of the sociologist Alan Wolfe, is "socially constructed":  "Morality thus understood is neither a fixed set of rules handed  down unchanging by powerful structures nor something that is  made up on the spot. It is a negotiated process through which individuals,   by reflecting periodically on what they have done in the  past, try to ascertain what they ought to do next.... Moral obligation   [is] a socially constructed practice."'"
• "Morality is a communal as well as a personal affair."
• "sociologist  George Herbert Mead and other "symbolic-interactionists" who  emphasized the social construction of reality"
• "Alan Wolfe's work  comes out of that tradition. If morality is created through social  interaction, then psychotherapy can be viewed as a form of specialized   social interaction in which current moral beliefs and sensibilities   are explored, affirmed, revised, or rejected and new ones are  created."
• "The therapist neither dictates moral rules nor claims to  know all the answers, but rather is sensitive to the often delicate  interplay of personal, familial, and community needs and responsibilities   involved in difficult moral choices."
• "Just as therapists do not supply  clients with feelings and desires but rather help clients discover  and work better with them, the same is true for moral beliefs and  sensibilities."
• "The client brings to therapy the moral raw material  that we work with collaboratively"
• "people are continually explaining   and justifying their own behavior and evaluating the morality  of others' behavior. The therapist is a consultant in this ongoing  process of moral reflection."
• "Most of us have a  moral sense, but ... some of us have tried to talk ourselves out of  it."
• "It is time for psychotherapists to stop trying to talk people out  of their moral sense."
• "If therapists are to be useful moral consultants-and I believe we  are moral consultants whether we claim to be or not-we will  have to uncover and evaluate our moral beliefs and moral sensibilities   more self-consciously than we have in the past."
• "the Golden  Rule - do unto others as you would have others do unto you-is a  far better guide to moral living than the reflexive morality of self-interest in mainstream American society."
• "Commitment to loved ones and  betrayal of that commitment are central moral themes in the  human drama played out in psychotherapy every day."
• "a committed, loving father who could give without  counting the returns and remain faithful without weighing the  alternatives"
• "One way of dealing with justice in therapy involves helping  clients perceive how they are being exploited and empowering them to assert their rights and needs."
• "Sometimes the injustice is personal and localized"
• "In an  unjust world, therapists can help people view their personal pain  through a wider lens than that of personal failing or family dysfunction."
• "Boszormenyi-Nagy has been developing a theory and clinical  model based on justice in family relations as a core factor in mental health and illness."
• "Boszormenyi-Nagy believes that the experience   of injustice-when parents take too much and give too little  to their children-has a corrosive influence on human development.   Adults who grew up in such families often have a sense of  "destructive entitlement": they use and abuse other people in a  misguided attempt to redress the inequities of childhood. They  view the world as divided into the exploited and the exploiters,  and they know whom they prefer. They are not able to give to the  next generation because the balance of justice-of giving and  receiving-has been so distorted in their lives."
• "It is easier, of course, for therapists to take moral stands when  the law is involved. If a client is contemplating a crime, then the  moral lighthouse casts clear illumination."
• "The clinical reality is  that clients rarely tell us they are contemplating breaking laws, but  they do tell us from time to time about behavior or plans that we  believe involve unjust treatment of people in their lives."
• "Questions work better when they do not transparently reflect the  therapist's own position."
• "I can see that fairness is  an important standard to you." This simple statement honors and  supports a core moral quality in the client, one that he or she may  need to access more and more in the coming months."
• "we  have a responsibility to help our clients avoid compromising themselves ethically"
• "Feminism, I have come to believe, is essentially about justice."
• "Understanding is not sufficient when people are being  treated unfairly."
• "she had to stop putting  herself down for not being superwoman"
• "Equitable marriages make for the best teamwork inside and outside the home."
• "Carol Gilligan's work  supports the observation that men respond more readily to issues  of justice and fairness, which are rooted in same-gender play and  work relationships from childhood onward, than to issues of caring, which are less prominent in their gender socialization."
• "Listening, reflecting, and affirming must precede any ethical challenge  in psychotherapy; clients must know that we have heard them and  care about them."
• "moral challenge requires a reasonably well-functioning therapeutic relationship in  which the therapist's nurturing and challenging have both proven acceptable to the client"
• "Therapists do not  want to become someone clients are accountable to for their ethical  decisions-a sure prescription for avoiding honest disclosure  about their behavior."
• "I maintain that we should be willing to use  more intense moral responses when the clinical circumstances  warrant in order to preserve the moral integrity of our clients  and to protect vulnerable people from being harmed by our  clients' actions."
• "My second problem with the morality-free approach is that it  encourages therapists not to examine their own beliefs, lulling  them into the illusory security of thinking they are fully objective."
• "the issues of self-truth and personal authenticity   must be accounted for in any morally sensitive therapy. They  must not be put in competition with morality in psychotherapy:  deciding whether to grow as an agent of one's own life or to he concerned   with the well-being of others is not an either-or choice."
• "As the philosopher Sissela Bok asserts,  lies give power to the deceiver over the one deceived, and patterns  of lying inevitably distort and erode human relationships, whether  or not the deceived person knows it."
• "Integrity is harmony between our moral beliefs and our actions."
• "maintaining his moral integrity, which is one of  the responsibilities of adulthood"
• "Insight-oriented therapies, beginning with  Freud, have emphasized truthfulness with self, that is, discovering  and honestly facing hidden or repressed dimensions of one's personality.   Humanistic and growth-oriented therapies, beginning  with Carl Rogers, have emphasized present self-awareness more  than mining for hidden historical and repressed truths about the  self, and they add the interpersonal dimension of "speaking my  truth" to others. They stress honest expression of wants and feelings,   but more for the sake of authenticity and self-development  than as a moral mandate. The emphasis is on my need and right to  express what is true for me, rather than on your need and right to  hear the truth from me. The distinction is not a trivial one."
• "people need healthy  family relationships, and healthy family relationships are based, in  part, on honesty. What is missing in this formulation is the obligation family members have to each other."
• "there is a distinction between being truthful and  speaking the truth. Truthfulness is limited by our self-knowledge  and our proclivity for self-deception"
• "Belief in one another's truthfulness, according to Sissela Bok, is  the cornerstone of social relations, without which cooperation and  trust cease to exist. She writes: "Trust in some degree of veracity  functions as a foundation of relations among human beings; when  this trust shatters or wears away, institutions collapse."" Therapists  should be concerned with truthfulness, then, because it is the  foundation of trust, without which human relations disintegrate."
• "Truthfulness is not only about personal insight or personal development   or psychological gain; it is also the moral foundation of  social relations."
• "In Sissela Bok's definition, a lie is "an intentionally deceptive message in the  form of a statement."' I am lying when I assert something I do not  believe in order to deceive you. Lying, then, unlike merely hiding  from you what I know, is an active process."
• "Lying, then, is different from keeping secrets, which has to do  with the domain of privacy."