Causality and Epistemology

1. Your client, Jane, comes to her second session with you highly distraught. Two nights previously she arrived home early from work and found her loving husband of 10 years cheating on her with her younger sister. She states repeatedly, through heaving sobs, that she can’t understand how this could happen, that their marriage was a “good” marriage. She asks repeatedly “Why would he do this?”
a. What caused Jane’s husband to cheat on her?
i. Is his cheating behavior healthy or unhealthy?
1. How do you know you’re right?
b. What is causing Jane’s distress?
i. Is her distress healthy or unhealthy?
1. How do you know you’re right?


2. Your client, Robert, is coming in for his 33rd session with you, as gloomy and as apathetic as he’s always been. He reports the same feelings and experiences he’s reported for the previous 32 sessions. He feels worthless, like he wants to die. He’s spent every day over the past 33 weeks in bed hating himself, lacking even the energy to commit suicide.
a. What is causing your clients behavior?
i. Is his behavior healthy or unhealthy?
1. How do you know you’re right?


3. The mother of your 8 year-old client comes into your office shortly before your session with him. She appears highly distraught and explains to you that she found her son torturing puppies in the backyard of their neighbor’s home. When she confronted her son about his behavior and grounded him to his room, he promptly lit his bed on fire.
a. What is causing your client’s behavior?
i. Is his behavior healthy or unhealthy?
1. How do you know you’re right?
b. What is causing the mother of your client to feel so distressed?
i. Is her behavior healthy or unhealthy?
1. How do you know you’re right?

4. One night, while visiting your family, you note that your uncle, who has always been a part of your life, is not present at the family gathering. You ask your family about where your favorite uncle is, and nobody responds to you. After a few distressing minutes of this, your grandmother pulls you aside and tells you that your uncle is in jail for molesting his children, your cousins.
a. What caused your uncle’s behavior?
i. Is his behavior healthy or unhealthy?
1. How do you know you’re right?

Assumptions Have Implications

Theories in psychology have unspoken assumptions and implications
The “from whence” and “to whence” of the theory
Assumptions are the fundamental ideas about the nature of reality that must be true for the theory to work
Implications are the consequences that logically follow from the assumptions: If ___ then ____
Example: Assuming we’re biologically determined
1. I’m a therapist that holds fast to an evolutionary model of behavior. I assume that all of human behavior is “hard-wired” and genetically determined. I read an article of a woman proclaiming the evils of adultery and how infidelity is “destroying today’s families”.
A. What would be my reaction to this article?
B. I’m a marriage counselor for a couple with one spouse is unfaithful, much to the distress of the other member of the marriage. How does my assumption that all behavior is “hard-wired” imply whether or not I should intervene with the unfaithful spouse?
C. If I choose to intervene, how would I intervene, given the assumption that all behavior is “hard-wired”?
Example: Assuming “it’s all good”
1. I’m a therapist that holds fast to a postmodernist model of behavior. I assume that all human behavior is morally relative, and that any dogmatic worldview (political, religious, or individual) is inherently harmful. I have a client in my office for an initial consultation who feels she has “sinned” and is greatly depressed, ashamed, and guilty for her behavior. I learn that by the standards of her deeply-held religion, she did indeed violate certain tenets of her faith.
A. Given my postmodern position, what would my reaction be to her shame, guilt, and grief?
B. How might I intervene with her, given that I feel that “it’s all good” and that dogmatism is inherently a problem?
Example: Assuming behavior is caused by unconscious forces
1. I’m a therapist from an analytic tradition. I assume that all of human behavior is due to unconscious processes (factors outside of our awareness over which we have no control). I’m meeting with a client who is greatly angry at his father. He feels his father betrayed his family by leaving his mother for a younger woman and moving suddenly to another state.
A. Given my analytic position, would I agree that the father is morally responsible for his own behavior?
B. If the father is not morally responsible, are my clients feelings rational or irrational?

Assumptions and Implications are rarely discussed
Themselves embedded in other assumptions and implications


Assumed Yet Overlooked: Agency
Agency = the ability to do otherwise, all things remaining equal
A HUGE assumption in our daily lives
Love, anger, shame, guilt, joy, often built on agency
Morality is not possible without agency
No choice = “good” and “bad” cease to make sense
If I have no agency (no choice) I cannot help what I do, hence it cannot be “bad” or “good”
Free will (utterly unconstrained behavior) seems impossible
We do have history, context, bodies
Understanding of contextualized agency
Critically examining what people can do, and what they cannot
Constraints not determinism

Standards for Critical Thought:
Clarity
You need to speak or present in a way that is clear and that the listener can understand
Accuracy
What you say really needs to be true (checkable empirically, qualitatively, etc.)
Precision
Giving precise enough details is very helpful and a good sign
Relevance
The statement should be relevant to the topic, to the issue, to the question
Breadth
There may be other ways of looking at the topic that need to be addressed
Logic
What you are saying now needs to follow directly and sensibly from what you said before


A theory is a series of two or more ideas that have a meaningful relationship
The relationship between them can be
1. Hypothesized
2. Presumed
3. Factually demonstrated
Basically: Theory = thought and theories are fallible

Responses to Fear of Thinking and Theorizing
Eclecticism
No escape
Nihilism
Work ceases
Denial
No improvement
Fighting familiarity
Fear Not! You can Theorize too!
Necessity of a “meta – theory” or a way of theorizing about theory
The nature of the relationship between ideas in a theory varies
Finding categories of the various ways ideas relate can be helpful
One such meta – theory is examinations of causality

1. The four causes
a. Material
i. What causes the thing is what it is made of
(1) What are you “made” of? Your biology causes your behavior
b. Efficient
i. What causes the thing are events that led up to it through time
(1) What is your history? It is your history that causes your behavior
c. Formal
i. The context of the thing, internally and externally
(1) What is your current context? Your context causes your behavior
d. Final
i. The end to which the thing or behavior exists
(1) What is your goal? Your goal causes your behavior
(a) Also called telos, study of purpose is teleology
2. Thought Exercise #1
a. There is a chair sitting in the middle of the room
i. What is the material cause of the chair?
ii. What is the efficient cause of the chair?
iii. What is the formal cause of the chair?
iv. What is the final cause of the chair?
3. Thought Exercise #2
a. John Smith has just been convicted of murdering 16 people in 5 states
i. What is a material cause for John’s behavior?
ii. What is an efficient cause for John’s behavior?
iii. What is a formal cause for John’s behavior?
iv. What is a final cause for John’s behavior?
4. Thought Exercise #3
a. Paula Purge sits across from you seeking treatment for her eating disorder
i. What is a material cause for her disorder?
ii. What is an efficient cause for her disorder?
iii. What is a formal cause for her disorder?
iv. What is a final cause for her disorder?
5. Thought Exercise #4
a. What forms of causality are assumed in the following vignette?
i. Genetic Causes of Depression
(1) Twin Studies
(a) Much of what we know about the genetic influence of clinical depression is based upon research that has been done with identical twins. Identical twins are very helpful to researchers since they both have the exact same genetic code. It has been found that when one identical twin becomes depressed the other will also develop clinical depression approximately 76% of the time. When identical twins are raised apart from each other, they will both become depressed about 67% of the time. Because both twins become depressed at such a high rate, the implication is that there is a strong genetic influence. If it happened that when one twin becomes clinically depressed the other always develops depression, then clinical depression would likely be entirely genetic. However because the rate of both identical twins developing depression is not closer to 100% this tells us that there are other things that influence a person's vulnerability to depression. These may include environmental factors such as childhood experiences, current stressors, traumatic events, exposure to substances, medical illnesses, etc.
(b) Research has also been done with fraternal twins. Unlike identical twins who have the same genetic code, these siblings share only about 50% of their genetic makeup and do not necessarily look alike. Studies have shown that when one fraternal twin becomes depressed, the other also develops depression about 19% of the time. This is still a higher rate of depression when compared to overall rates for the general public, again pointing towards a genetic influence in the development of clinical depression.
(i) (both vignettes from http://www.allaboutdepression.com/cau_03.html)
6. Your assumptions about causality imply some treatments and not others
a. If I assume that my client’s issues are caused by their biology, what treatments would I use?
i. Which treatments would I NOT use?
(1) Consequences?
b. If I assume that my clients issues are caused by their past, what treatments would I use?
i. Which treatments would I NOT use?
(1) Consequences?
c. If I assume that my clients issues are caused by their context, what treatments would I use?
i. Which treatments would I NOT use?
(1) Consequences?
d. If I assume that my clients issues are caused by their mistaken goals, what treatments would I use?
i. Which treatments would I NOT use?
(1) Consequences?
7. Dealing with the whole person
a. In psychology, we tend to value just two causes, efficient and material
i. Most measurable, and hence most “scientific”
b. Two consequences to that value
i. It removes volition/agency
(1) A therapist that attends to your past, not to you
(2) A therapist that attends to your biology, not to you
ii. It removes moral responsibility
(1) Sometimes a good thing, sometimes not
(a) Good when behavior truly is a-volitional
(b) Bad when behavior is truly volitional

Causality, however, has direct implications for epistemology (how knowledge is "caused")

Epistemology
a. Epistemology is our theorizing about our ways of gaining knowledge
i. Episteme = theoretical knowledge
ii. Gnosis = experiential knowledge
iii. Oida = knowledge from books
(1) Different theories about ways of knowing
(a) Critical for science
(b) Critical for therapy
(c) Yet another meta-theory
b. Valuable for your first paper (potentially)
i. How do people know what they know?
ii. How does such knowledge come about?
iii. Why do some people know some things, while other people know other things?
iv. Can problems occur in the process of knowing/learning?
v. Can we know anything learned without our physical senses?
2. Lockean Epistemology (Empiricism)
a. Empiricism: From “experience” in Latin
i. Common, unquestioned
(1) Born “tabula rasa”
(a) We derive knowledge from two things:
(i) Sensation (from our seven senses)
1) Sensation is the outside world effecting our senses
(ii) Reflection (remembering that which we have sensed)
1) Reflection is developed through our experience with the outside world helping us categorize our behavior
(b) Ultimately, external forces impinge upon our senses causing sensation directly, which is then remembered
(i) What we know is at the mercy of what we sense
(ii) Our knowledge is strictly A Posteriori
ii. If my assumptions about human knowledge were predominantly empirical as a therapist, how would that affect my treatment of my clients?
(1) What sorts of interventions would I provide?
(2) What sorts of interventions would I not provide?
3. Kantian Epistemology (Rationalism)
a. Rationalism: From ratio “reason” in Latin
b. Less common, often unconsidered
i. Descartes: The use of skepticism
(1) Doubting (even doubt) = reason
c. Socratic dialogue
d. Einstein’s gedanken
i. Recognized as a scientist, but breakthroughs were non-empirical
e. Mathematics
i. No empirical referent
f. Immanuel Kant: A priori knowledge & categories of understanding
i. A priori means “before experience”
g. Division between noumenal and phenomenal realms
i. Noumenal = world as it is apart from our understanding of it
ii. Phenomenal = world as we actually experience it
h. Categories of understanding exist a priori
i. Rose colored glasses: phenomenal structuring noumenal
(1) Time, space, shape, size
(2) Ultimately, knowledge is caused by our structuring of the world
(a) We are disturbed not by events, but by the views which we take of them
(i) Epictetus
i. If I were a therapist who assumed that what people know is predominantly how they habitually construct their external and internal world, what sorts of interventions would I provide?
i. Which interventions would I not use?
4. Exercise! (But without the sweating and panting)
a. You’re seeing a client, and you assume that the client’s disorder comes from past experience. (They had a pathogenic environment)
i. What epistemology are you assuming?
b. You’re seeing a client, and you assume that the client’s disorder comes from their unconscious mind interfering pathologically with their world
i. What epistemology are you assuming?
5. Don’t we just need ONE epistemology for crying out loud?
a. Empiricism limited in its explanatory power
i. Things can be meaningful without empirical referent
(1) Mathematics, statistics, religion, virtue, duty
b. Rationalism is limited in its explanatory power
i. We cannot change our categories of understanding
(1) True creativity limited
(2) Explaining fundamental differences in understanding is problematic
c. Search continues for the “best” epistemology
6. Alternative 1: Social Constructionism
a. The process of understanding is no longer within a given individual
i. Understanding occurs within relationships
b. Humans are fundamentally language using creatures
c. What is known is constructed through language and interaction
d. Problem: Everything known is socially constructed
i. Truth, lies, right, wrong, etc. all constructed
(1) (we’ll talk about degrees of relativism next week)
7. Alternative 2: Modes of Engagement (Hermeneutic Interpretivism)
a. Fundamental assumption: We are engaged or embedded in our world to varying degrees
i. Empiricism and rationalism posit separation between self and world = subject/object distinction
ii. Constructivism makes crucial concepts items for ironic play in discourse (relativizes fundamental realities of being)
b. Hermeneutics (interpretive) partially dissolves subject/object distinction, furthers understanding
i. Present-at-hand (Present-ness) = Detached, reflective mode of experimentation and math. Subject & object separate, leads to skewed (constructed) understanding
ii. Ready-to-hand (Occurrent-ness) = Active engagement, practical knowledge and learning less skewed by culture
(1) All of this knowledge is contextualized knowledge
iii. Treating a map as a real city = treating experimental results as immediately applicable in lived existence
(1) Studying “objectively” is to study an abstraction
(2) Subjectivity/objectivity fused into “the lived world”
iv. No unbiased interpretation, “interpretations are always and already interpretations of something”
(1) We understand the world both according to what it is, and what we make of it
(a) Yup. Both, at the same time
(2) We are “thrown” into a world of language, meaning, history, morality
(a) Our thrown-ness informs our interpretation of the world
(b) As does our engagement with the world
(i) Do we have time to talk about the hermeneutic circle?
c. Exercise time!
i. Often, wrapping our heads around constructivism and interpretivism can be challenging, but we’re up for it!
(1) If I’m a therapist who assumes that all knowledge is socially constructed in relation to others, what sorts of interventions would I use with my clients?
(a) Which would I not use?
(2) If I’m a therapist who assumes that all knowledge is interpreted knowledge of ourselves and our world around us grounded in our own context, what sorts of interventions would I use with my clients?
(a) Which would I not use?

Our assumptions in terms of causality and epistemology also have implications for our ethical and moral view.

Moral and Ethical Assumptions in Counseling
a. Principle ethics
i. The belief that you have to strictly codify “right” and “wrong” behavior
(1) Usually what gets codified is a socially constructed understanding that itself draws from commonly held general principles in the population
ii. Ethical codes are written very broadly, specific situations are mentioned only rarely, which can be frustrating if you need help with a particular ethical issue
(1) Scene in the Simpson’s Movie “There’s no answers here!”
(a) Same problem with ethical codes, they present a mindset, general rules for ethical behavior
(b) In essence, the ethical codes are necessary (they form a base) but not sufficient (they are necessarily broad and imprecise)
iii. Ethics specify behavioral guidelines for a given group of people
(1) Club membership
(a) You can break ethics sometimes without breaking the law
(2) Law specifies what you can’t do legally
(a) Goes for everybody, can land you in jail if you break them
(3) You know you’re in legal trouble if:
(a) Legal proceedings have been initiated
(b) Lawyers are involved
(c) You are in danger of having a complaint of misconduct filed against you
iv. Sometimes the law and the code don’t get along
(1) What you are ethically bound to do may be legally problematic
(a) Consult a lawyer (hate to say it, but it’s true)
(i) Issues due to counseling minors, ethics vs. law
(2) Some ethics codes (like APA) specify that if there is a contradiction between the law and the code, obey the law in a manner to best approximate the ethical code
b. Principle ethics is a philosophical orientation towards “right” behavior
i. Establishing a set of obligations and the methods to meet said obligations
ii. Using said method to solve a dilemma/dilemmas
iii. Use the framework to solve future dilemmas
(1) It’s very “rule-focused”
c. Virtue ethics are aspiration-al
i. Four philosophical core virtues:
(1) Prudence
(2) Integrity
(3) Respectfulness
(4) Benevolence
ii. Here’s a sample list of virtue ethics in psychology
(1) 1. Autonomy
(a) Self-determination, freedom to choose
(i) We shouldn’t interfere with that
1) But often we do
(b) This is one of the reasons why it is so important to be aware of one’s own values
(c) We won’t know we’re pushing a moral agenda unless we know we have one
(i) Always present clients options, even if you don’t like some of them
(2) 2. Nonmaleficence
(a) Avoid doing harm (actively or passively)
(i) Vindictiveness disturbingly common in our field
1) “I’m giving them what they deserve”
2) Fine line sometimes between tough love and just petty meanness
a) Be aware of cultural differences when diagnosing
i) “White man’s clinic”
(3) 3. Beneficence
(a) Promote “good” for others
(i) Defined as “dignity and welfare”
1) Loaded with assumptions . . .
(b) Note that this particular virtue is PRO-active
(i) Have you done any good in the world today?
1) Be aware of the client’s context and what “good” is for them
2) Don’t dismiss your own “good” but try to find a middle ground with them
3) One culture CAN positively inform another culture
a) What I learned about the value of extended family
(4) 4. Justice
(a) Be fair to everyone, don’t have double-standards
(i) Justice is an issue when interventions don’t work, or are harmful with certain populations
(ii) Justice is an issue when assessments work for one group, but not another (yet are claimed to be valid)
(iii) Justice is an issue when you have a double-standard in your pro-bono work
(iv) Justice is an issue when you give certain clients the benefit of the doubt and not others . . .
(5) 5. Fidelity
(a) You make a promise, you keep that promise
(i) Your word becomes FACT
(ii) You are LOYAL to your clients
(iii) You need to live up to your end of informed consent
(iv) Clients need to trust the therapeutic relationship
1) My own experience with counseling
a) My counselor no-showed to 50% of our sessions
(6) 6. Veracity
(a) Closely related to fidelity
(b) Be truthful with your clients
(i) Lies of commission vs. lies of omission
(ii) Painful honesty is sometimes required of us
(iii) Clients need to know that they can trust what you say
(iv) “I’m going to speak to medical to see if we can get you an appointment sooner”
1) By golly, you’d better go and chat with medical
2. Ethics do not arise in a vacuum
a. They are themselves philosophical ideas, loaded with assumptions
b. Note that ethical virtues (and ethical principles) focus around helping an individual, usually to feel better or behave more productively. This is a fundamental assumption of counseling theory
c. We, as a society, very much value such worthy ideas as individual freedom, happiness, and the inherent rights of the individual
i. This has HUGE positive benefits
(1) Freedom from oppression, repression, and arbitrary authority
(2) Both individually and socially
(3) The ability to choose one’s own destiny
(a) Counseling both mirrors society and magnifies it
(i) We help perpetuate both the positive and negative of these values
d. Psychology furthers the modern ethos of the importance of individual rights, freedoms, and pursuits of happiness
i. The individual, however, is seen as a “bounded, masterful self”, its own source of happiness and misery (Cushman)
ii. A “punctual” self, a singular point of consciousness, radically disconnected from other points of consciousness (also Cushman)
(1) Denies the power of relationality
(2) Denies powerful moral obligation, responsibility, etc.
(a) “Only you can make you happy”
(i) WHAT?????
e. Pursuit of individual happiness and the good life are certainly worthwhile goals
i. Possible unfortunate side-effects of this:
(1) People looking out for themselves and their own benefits first, without concern to greater societal needs
(2) Greater disconnection with others as people increasingly look within for meaning
(3) Go to psychotherapists to ameliorate the necessary anomie that accompanies this
(4) Only to have it perpetuated by individualistic therapy
f. Another effect of the individualistic nature is the centrality of meaning in the self
i. The individual knows, subjectively, what the source of his or her individual happiness is
ii. Given that happiness is the ultimate goal, and only the individual knows what will make them happy, the individual is the ultimate arbiter of what is “best”
(1) All individuals differ - what is ultimately best differs
3. The issue of Relativism
a. Constructionists object to the individualism of psychology
i. Posit instead that meaning is not located within a given individual, but rather within the meanings created by society
ii. We are, rather than completely, ontologically, separated from others, we are instead co-constructed by society, fundamentally inseparable from others in society
b. Although constructionism does a lot to explain our engagement with society and meaning, there is still a problem: If moral meaning comes from society, and societies differ, morals are relative to societies
i. Where do individual cultures end?
(1) Countries, states, counties, religions organizations, fraternities, families, even individuals
ii. Different approach, same ultimate problem
c. Disadvantages of relativism
i. It allows us to treat crucial moral concerns as items for “ironic play” in our counseling
ii. We have to treat them as serious to respect the clients, but they can’t really be serious because everything is relative - ironic
iii. Cultural clashes are inevitable
(1) “I’ll only see the counselor if she’s Catholic” (Mormon, Baptist, Buddhist, etc.)
(a) “Will he respect my values, even though the culture of psychology denies the validity of values?”
(2) “Men’s milk” – you would be legally obligated to report abuse
(3) Relativism is inconsistent
(4) Could it be that we don’t feel values are fundamentally relative?
(a) When we feel strongly about things we do not feel that our emotion is invalid or stupid
(i) If everything is relative, why fight, why advocate, why change?
1) Why is happiness “good?”
a) Why would anyone want to perpetuate happiness except for very relativistic (and ultimately invalid) reasons?
(5) Illogical “the ultimate truth is that there is no truth”
(a) The ultimate in living truthfully is to live as though truthful living was impossible . . .