Journal of Religion and Health, Vol. 22, No. 1, Spring 1983
Psychotherapy and the Locus of Control RICHARD C. ERICKSON A B S T R A C T : Underlying various actions of both the t h e r a p i s t and the p a t i e n t are expectations a b o u t the measure to which an individual's experiences are the product of powerful external forces or of the person's own actions and decisions. While most of our anthropological theories support the notion t h a t a person's experience is subject to an external locus of control, neither t h a t view nor the opposite emphasizing freedom and a u t o n o m y is adequate for the therapeutic enterprise. THere are elements of t r u t h in b o t h positions t h a t ned to be incorporated in therapeutic expectations if the enterprise is to proceed in an orderly fashion.
No psychotherapist or pastoral counselor proceeds without a more or less well-informed conception of how human beings function. Such a conception may be muddled, at times internally inconsistent, and almost certainly inadequately articulated. But whatever the mixture of implicit and explicit elements, this conception informs the therapist's actions. Such a conception helps us define the goals for which we strive in therapy, however hazy those may be, and more certainly specifies the events we will attend to and designate as therapeutic. In attempting to articulate how human beings function and how they ought to function, we are confronted with a surfeit of riches. There is no shortage of psychological, sociological, or theological anthropologies to choose from, none of which is without some positive values that render it plausible. Furthermore, at this level of analysis, empirical tests will usually fail us: Freudian patients will conveniently produce Freudian dreams, Jungian patients Jungian dreams, Adlerian patients Adlerian dreams; behavioral clients will behave behaviorally, and "sinful' clients will exhibit sinful practices or attitudes. Something a bit more basic than these elaborations must be at issue. One such underlying set of expectations that may constrain and inform the actions of both the therapist and patient relates to the psychological construct of locus of control (a construct that in some ways contains echos of the earlier philosophical and theological discussion of free will and determinism). The construct locus of control refers to the individual's perception of the measure to which his experience is the product of luck, fate, or powerful others (external), rather than the product of his own actions and decisions (internal). Reprint request may be addressed to Professor Richard C. Erickson at P o r t l a n d Veterans A d m i n i s t r a t i o n Medical Center, D e p a r t m e n t of Medical Psychology, Oregon Health Sciences University, Portland, Oregon. 0022-419W83/1300-0074502.75
74
~ 1983 Institutes of Religion and Health
Richard C E n c k s o n
75
An extensive psychological literature initiated by Rotter's work ~describes the impressive impact of such perceptions or expectations on people's behavoirs For example, the speed with which people learn to adapt to changes in environmental demands or learn from their mistakes is a function of their perceived locus of control. It is not our intent to review this literature, but to discuss the impact of such underlying perceptions or expectations on the psychotherapeutic relationship, specifically on the attitudes and values of the therapist. Echoes of the larger determinism/free will discussion will persist throughout this paper, but only in order to remind the reader that these issues are not idiosyncratic to the counseling relationship
External locus of control Most of our anthropological theories lend support to the notion that a person's experience is subject to an external locus of control, that is, that the individual's experience is dependent on and determined by variously named powerful forces that are in one way or another external to the self. Such a notion has had a long and successful history. Popular and philosophical notions of fate dominated the ancient world. The Augustinian and Reformed Christian traditions in effect deprived the individual of a sense of personal control by their thoroughgoing attempts to ascribe limitless power and knowledge to God. The Renaissance world was not without its renewal of the ancient notions of the fates, as one can see by viewing dramas from the period. The seventeenth through nineteenth centuries saw the rise of another set of explanatory constructs, but not a shift in vantage point. Theological and philosophical determinisms were replaced by scientific determinisms. The exchange of an inexorable personal God for blind and mechanistic biological, environmental, and historical forces merely depersonalized the external locus of control. The mechanistic assumptions governing the natural sciences (based on a now dated Newtonian approach to things) provided the philosophical assumptions for the fledgling field of psychology. Freud and the early behaviorists certainly presumed this view of things. Behaviorists portrayed the individual as a mere focal point for the convergence of powerful environmental forces, while in classical psychoanalytic theory the refuge of the interpsychic world was populated with reified contructs such as the "id," the "super-ego," the "unconscious," and the like, constructs that suggested powerful and uncontrollable forces imbedded in the individual but nonetheless "external" to him in their ability to control his behavior. One consequence of this way of thinking is that therapists who wish to rationalize their procedures as "scientific" have tended to perceive and describe their patients' behaviors as the product of external forces. Once a therapist proceeds on the assumption that the individual's adjusted or maladjusted behavior is determined by "external" forces, the thrust of therapy is presumably clear. Since the patient is the product of external forces, he is not to be blamed for his behavior but is to be understood. Therapy itself may have as its goal the attainment of
76
Journal of Religion and Health
understanding or "insight": Patients are to learn to acknowledge and accept {and perhaps submit to} that reality which constrains their actions and out of such a stoic alchemy learn to produce some measure of freedom. Alternatively, in the simple behavioral model, the environment must be modified to change the individual's behavior. The core inconsistencies of deterministic theories of therapy are obvious. Since all is determined by "outside" forces, it is less than clear how either the therapist or the patient can be regarded in any way as an active agent in the therapeutic process. Similarly, questions of accountability or responsibility are rendered meaningless. Historically, deterministic thinkers have attempted to respond to such problems. Theological thinkers like Paul, Augustine, and Calvin, when confronted with the patent injustice of an all-powerful God holding his determined creatures accountable for their unacceptable behaviors, thundered back variations on, "How dare you ask such a question?" In the more silent universe of Stoicism and the mechanistic world of science, blasphemy has no meaning and such a thunderous response no force. Instead, Stoics exempted the inner world of the individual from the more general determinisms and made the person responsible for the upkeep of his own house; one's attitude could be controlled even if one's future could not. But when the depth psychologies inhabited even this small space with intrapsychic determinisms, an internal arena of self-determination has become problematic, if not completely implausible, and therapists were in practice saved only by their inconsistencies. In behaviorism and classical psychoanalysis, therapists are summarily declared active agents by curiously being exempted from a universal process that binds the patient. The logic for such an exception is obscure, but the fact that such an exception is made is fortunate. The patient is less fortunate. It may comfort him to learn that his problematic behaviors are the products of powerful environmental or "disease processes" and that he is "not to blame" for them, but once he understands the "causes" for his behavior, what then? Once the notions of responsibility or accountability have been set aside for convenience' sake, it is hard to restore them meaningfully to the discussion. If the goal of therapy is to understand oneself, then to understand oneself as determined is a meaningful goal, although indeed the attainment of such an insight seems another curious exception in a deterministic universe. If the goal is change of some sort, the process is less clear. It could be that the attainment of insight will itself result in the disappearance of the unwanted behavior or feeling, much as a cancer shrivels in the presence of radiation; but the history of psychotherapy has given little ground for such a hope. More often the attainment of insight has been followed by renewed exhortations to behave as an active and responsible agent in determining the course of one's future life in a curious and sudden turn of events. Perhaps this was is the only way to the promised land, but experienced therapists see plenty of examples of patients who get lost and wander in the wilderness--patients who persist in behaving in unproductive
Richard C E n c k s o n
77
and self-destructive ways b u t who can elaborate at length on the psychosocial explanation for their state. It does little good to blame them for this; we, after all, are the ones who provided them with such deterministic rationales in the first place, and they presumably should not be faulted when we change horses in midstream. Of course, I would not want to deny the power of biological disease processes, whether pneumonia or diabetes or schizophrenia. I would argue, however, that it is a disservice to view any patient through the peephole of a diagnosis and to blame the disease (or environment} in order to exonerate the patient. Therapists usually find that this seductive short-run strategy is destructive in the long run. Hospitals are loaded with recidivists who solemnly explain, " I ' m Peter, and I am a paranoid schizophrenic," using such a declaration to exempt themselves from accountability for their behavior and responsibility for their lives. Time and again psychiatric staffs' deterministic illness explanations wear thin with time, and they seemingly have no alternatives to blaming the patient. The disease of diabetes m a y represent the most useful analogy. The patient has probably not caused certain biological imbalances b u t is still properly held accountable for how he manages them and for how he conducts himself in the community. There are always limiting cases, of course--usually fewer than we would like to a d m i t - - b u t the perception that an individual's behavior is determined by powerful foreign forces beyond his control is a treacherous one, not to be entertained lightly or for the sake of temporary convenience. Once lod~ed, deterministic exnlanations are difficult to dislodge..
Internal locus of control A second history declares that humans are the captains of their fate and masters of their souls, proposing that what happens is the consequence not of external forces b u t of one's own choices and actions. This explanation is congenial to many Americans but has seldom convinced reflective persons. Since the case for determinism has seemed overpowering, assertions of individual freedom and potency have usually maintained their force b y simply denying or ignoring the claims of the more deterministic systems. So it is that P e l a g i a n i s m and A r m i n i a n i s m have remained in the s h a d o w of Augustinianism and Calvinism, and that many existential philosophies from Kierkegaard to Sartre maintain themselves by a simple and stubborn denial of the personal relevance of Hegelian or scientific considerations. In all of this one does not sense that such philosophies or theologies have moved beyond the deterministic s y s t e m s that spawned them; one rather senses a stalemate. Third force or humanistic psychologies reflect the same dynamics in their reaction to the more deterministic psychodynamic or behavioral theories. The autonomy and self-determination of the individual are passionately asserted. The impact of environmental constraints is minimized or simply set aside as irrelevant to the therapeutic task. Self-determination is restored to the individual b u t not accountability. This happens for two reasons.
78
Journal of Religion and Health
First, the individuals are taught that they are responsible--but only to themselves. The goal of therapy in one form or another is "self-actualization." If anything, the demands of the community and environment are seen as forces that tend to induce one to live in inauthentic ways. Second, transcending values are obscured b y a pervasive relativism of values. The pluralism of modern society is taken to its logical extreme, and each individual is enjoined to declare total independence from all others and their expectations with, "I am I, and you are you . . . . ,,2 Such declarations of total independence prove intolerable, and we often witness such individualists submerging themselves in exotic value s y s t e m s {e.g., Eastern religions}, such exotic s y s t e m s supplying a new set of norms for the individual until their novelty wears off. Therapists operating in such a normless context are indeed in a quandary. They can represent no goals, because normative goals are not acknowledged; and they can exert no influence, because such influence is regarded as improper or impossible. Consequently, clients are confronted with therapists who deny that they direct or affect what happens {since they are nondirective) or deny they are therapists at all. Such denials represent either a tour de force of confusional technique or charlatanism; to be paid to contribute nothing and admitting so is surely a resourceful strategy. To be sure, such an experience m a y be entertaining, but the consumer takes it seriously at his peril, and reentry problems into the real world can prove catastrophic. These approaches have provided a diversion for the intelligent and successful for the most part; the poor and less fortunate are likely to view such approaches as merely fantastic.
A n alternative H o w is this stalemate to be resolved? The notion of "locus of control" defines the hinge on which the argument turns: Who or what is the effective agent responsible for an undesired behavior or experience? The problem has been given additional force by the societal assumption that someone or something must take the blame for the undesired behaviors. This judicial view informs our everyday transactions with one another. It is most graphically represented in the Judeo-Christian tradition by Old Testament sacrificial laws and by Anselm's satisfaction theory of the atonement. The therapeutic arena, it is argued, provides one place where an individual can acknowledge socially destructive and self-destructive ways of life and can work toward changing such behaviors without the fear of being blamed. That is commonly understood. B u t as therapists we m u s t take great care what grounds we use for withholding censure. Historically two grounds have been provided, as we have seen. The first denies that the person is the responsible agent, pointing instead to some form of external force. The second denies or ignores the reality of material and social constraints in the environment, making the individual answerable only to himself.
Richard C. E r i c k s o n
79
The problem is that reality demands both that the person be regardedfas an active agent and that the material and social environments be accorded constraining powers. Therapists who minimize or disregard either of these realities in the process of therapy risk resting their work on mythologies that they will sooner or later be forced to deny or qualify. Reality will inevitably insinuate itself. The therapeutic task demands that therapist and patient maintain clear c o m m i t m e n t s to the reality that each person is an active agent influencing and being influenced by the immediate and extended material and social environment. These commitments must pertain from the onset, and neither reality should fade nor be pushed out of focus for any appreciable time. Adler's approach, 3 Bandura's sophisticated behavior theory incorporating the notion of reciprocal influence, 4 and modern psychodynamic theorists like Arieti, ~ represent examples of this way to understanding the therapeutic task. Most of the great Catholic theologies from Irenaeus through Aquinas to modern times (including Roman, Anglican, Eastern, and Protestant middle-of-the-road theologies) maintain this proper tension. More recently, process philosophies and theologies 6 provide a fresh and more commodious vantage point, a vantange point that is consistent with current perspectives in the natural sciences. 7 Suppose now that the therapist or counselor sees himself and his client as holistic organisms creatively pursuing goals given value by the way each organism perceives the world within the constraints of a social environment (Adler) and t h a t this process continues to evolve over time (process thought). What are some implications for therapy? First, while the individual's behavior is like]y to be better understood given a knowledge of his history and environmental situation, it is unlikely to be the simple effect of the same. This is so because even in the simplest cases, current behavior is the product of an interaction between the individaul and his environment, not the simple function of the individual's environment (internal or external). Stated more concretely, all persons suffering the probable biochemical deficit contributing to a diagnosis of schizophrenia do not limp through life the same, nor do all children from broken homes or slum neighborhoods turn out the same. This unpredictability is a reflection of reality, not a reflection of our lack of knowledge of reality; our laws will always be statistically true, not mechanistically true, because of the nature of reality. To the determinist determined to " g e t to the bottom of things" this is frustrating, but to the therapist and his client it is reassuring: the task of change is not simple, but it is at least possible. Second, the reality of things is more complex than either the therapist or patient dared to hope or fear. There are m a n y examples of this. We realize the future is not a simple product of the past. We know the individual cannot proceed with simple disregard for his environment. To say a behavior is purposeful is not necessarily to say that it is done on purpose. To assert that we pursue goals we deny to awareness is not to assert that we can arrive at a state of total enlightenment. The question, "Which came first, the chicken or
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Journal of Religion and Health
the egg?" has no answer. While problematic behaviors and schemes are rooted in past experiences and while their exposure and uprooting m a y lead to the solution of present problems, there is no guarantee future problems will be solved or obviated by present acts. One cannot arrive once and for all. ~ Third, the therapist is not above it all, b u t neither is he simply a fellow traveler on a journey across (criss-crossing?) an open field. This suggests the therapist can always be thrown off the track by patients' seductions. M o s t patients will sooner or later home in on the therapist's vulnerabilities; his persisting needs to be seen as "fair" or "powerful" or "understanding"or "responsive to the patient's feelings," and the like. This also implies the path we travel with our patients has physical and social boundaries. Concessions to autonomy or self-actualization have their limits. The physical and social environments do have boundaries which are no less real for being finally imprecise. The therapist is well advised to keep such contraints in the foreground of his perceptual field as well as that of his patient, lest both be seduced into the fiction that one can have things both ways. Natural or logical consequences do properly follow actions. Fourth, the therapist and the patient are responsible and accountable for their behaviors and subject to their consequences even if they are not blameworthy. The patient is not to be "demoralized" by being declared impotent by means of deterministic explanations. The same energies that contributed to the pursuit of mistaken goals can be placed at the service of socially useful and personally satisfying goals. At the same time, the experienced therapist is disinclined to censure the patient. A good deal of foolishness and very little perverseness exist in an individual's unsuccessful a t t e m p t s to address life's complex tasks. To understand is to credit the patient with resourcefulness given his perception of the demands of reality. So we respect the patient, a resourceful rascal who has " m a d e the best of it" under given perceptual and environmental circumstances. It is not easy to maintain such a posture. To grant the patient responsibility for his behavior (even "under the circumstances") is to hold him accountable and subject to consequences2 B u t to admit the patient is "accountable" is to risk the entrance of accountability's bastard brother "blame." As we have seen, however, efforts to exempt the patient from blame by depriving him of responsibility are too costly. We have no alternative b u t to effect a difficult therapeutic balancing act, proceeding with the skill of a Mohawk crossing a high girder in a buffeting wind. If we fail, our therapeutic enterprise will fall to its death upon the rocks of determinism or in the whirlpools of relativism and "autonomy." The more subtle thinking of St. Irenaeus is reassuring here. Perhaps our failings partake less of high drama than the Augustinian legend would suggest. Perhaps they are, after all, of the nature of mistakes and selfdeceptions made by the immature. Such mistakes and self-deceptions certainly make the journey unnecessarily complicated and difficult but not necessarily hopeless, precisely because we have never been left abandoned or unloved--or so the gospel story has it.
Richard C Erickson
81
References 1. Rotter, J.B., "Generalized Expectancies for Internal versus External Locus of Control of Reinforcement," Psychological Monographs General-Applied, 1966, 80, (1, Whole No. 609}, 1-28. 2. Perls, F., Geltalt Therapy Verbatim. Lafayette, California, Real People Press, 1969, p. 4. 3. Mosak, H., and Dreikurs, R., "Adlerian Psychology." In Corsini, R., ed., Current Psychotherapies. Itasca, Illinois, Peacock, 1973. 4. Bandura, A., "Behavior Theory and the Models of Man," American Psychologist, 1974, 29, 297-309. 5. Arieti, S., The Will to be Human. New York, Quandrangle, 1972. 6. Brown, D.; James, R.E.; and Reeves, G., eds., Process Philosophy and Christian Thought. Indianapolis, Bobbs-Merrill, 1971; Cobb, J.B., and Griffin, D.R., Process Theology: An Introductory. Exposition. 7. See Wolf, F.A., Taking the Quantum Leap. San Francisco, Harper & Row, 1981. Particularly helpful discussions of the relationship between science and religion in the post-Darwinian, post-Einsteinian era are to be found in the writings of Barbour, I.G., Issues in Science and Religion. New York, Harper & Row, 1966; and Myths, Models, and Paradigms. New York, Harper & Row, 1974; Peacocke, A.R., Science and the Christian Experiment. London, Oxford University Press, 1971; and Creation and the World of Science. Oxford, Oxford University Press, 1979. 8. Erickson, R., "The Vulnerable Hero: Theology and the Goals of Therapy," J. Religion and Health. 1973, 12, 328-336. 9. --, "Viewing the Therapeutic Community through Adlerian Spectacles," International J. Group Psychotherapy. In Press. 10. "Reconciling Christian Views of Sin and Human Growth with Humanistic Psychology," Christian Scholars Review, 1978, 8, 114-125. An excellent selection of St. Irenaeus's writing is to be found in Bettenson, H., ed., The Early Christian Fathers. London. Oxford University Press, 1969.
Psychotherapy and the Locus of Control RICHARD C. ERICKSON A B S T R A C T : Underlying various actions of both the t h e r a p i s t and the p a t i e n t are expectations a b o u t the measure to which an individual's experiences are the product of powerful external forces or of the person's own actions and decisions. While most of our anthropological theories support the notion t h a t a person's experience is subject to an external locus of control, neither t h a t view nor the opposite emphasizing freedom and a u t o n o m y is adequate for the therapeutic enterprise. THere are elements of t r u t h in b o t h positions t h a t ned to be incorporated in therapeutic expectations if the enterprise is to proceed in an orderly fashion.
No psychotherapist or pastoral counselor proceeds without a more or less well-informed conception of how human beings function. Such a conception may be muddled, at times internally inconsistent, and almost certainly inadequately articulated. But whatever the mixture of implicit and explicit elements, this conception informs the therapist's actions. Such a conception helps us define the goals for which we strive in therapy, however hazy those may be, and more certainly specifies the events we will attend to and designate as therapeutic. In attempting to articulate how human beings function and how they ought to function, we are confronted with a surfeit of riches. There is no shortage of psychological, sociological, or theological anthropologies to choose from, none of which is without some positive values that render it plausible. Furthermore, at this level of analysis, empirical tests will usually fail us: Freudian patients will conveniently produce Freudian dreams, Jungian patients Jungian dreams, Adlerian patients Adlerian dreams; behavioral clients will behave behaviorally, and "sinful' clients will exhibit sinful practices or attitudes. Something a bit more basic than these elaborations must be at issue. One such underlying set of expectations that may constrain and inform the actions of both the therapist and patient relates to the psychological construct of locus of control (a construct that in some ways contains echos of the earlier philosophical and theological discussion of free will and determinism). The construct locus of control refers to the individual's perception of the measure to which his experience is the product of luck, fate, or powerful others (external), rather than the product of his own actions and decisions (internal). Reprint request may be addressed to Professor Richard C. Erickson at P o r t l a n d Veterans A d m i n i s t r a t i o n Medical Center, D e p a r t m e n t of Medical Psychology, Oregon Health Sciences University, Portland, Oregon. 0022-419W83/1300-0074502.75
74
~ 1983 Institutes of Religion and Health
Richard C E n c k s o n
75
An extensive psychological literature initiated by Rotter's work ~describes the impressive impact of such perceptions or expectations on people's behavoirs For example, the speed with which people learn to adapt to changes in environmental demands or learn from their mistakes is a function of their perceived locus of control. It is not our intent to review this literature, but to discuss the impact of such underlying perceptions or expectations on the psychotherapeutic relationship, specifically on the attitudes and values of the therapist. Echoes of the larger determinism/free will discussion will persist throughout this paper, but only in order to remind the reader that these issues are not idiosyncratic to the counseling relationship
External locus of control Most of our anthropological theories lend support to the notion that a person's experience is subject to an external locus of control, that is, that the individual's experience is dependent on and determined by variously named powerful forces that are in one way or another external to the self. Such a notion has had a long and successful history. Popular and philosophical notions of fate dominated the ancient world. The Augustinian and Reformed Christian traditions in effect deprived the individual of a sense of personal control by their thoroughgoing attempts to ascribe limitless power and knowledge to God. The Renaissance world was not without its renewal of the ancient notions of the fates, as one can see by viewing dramas from the period. The seventeenth through nineteenth centuries saw the rise of another set of explanatory constructs, but not a shift in vantage point. Theological and philosophical determinisms were replaced by scientific determinisms. The exchange of an inexorable personal God for blind and mechanistic biological, environmental, and historical forces merely depersonalized the external locus of control. The mechanistic assumptions governing the natural sciences (based on a now dated Newtonian approach to things) provided the philosophical assumptions for the fledgling field of psychology. Freud and the early behaviorists certainly presumed this view of things. Behaviorists portrayed the individual as a mere focal point for the convergence of powerful environmental forces, while in classical psychoanalytic theory the refuge of the interpsychic world was populated with reified contructs such as the "id," the "super-ego," the "unconscious," and the like, constructs that suggested powerful and uncontrollable forces imbedded in the individual but nonetheless "external" to him in their ability to control his behavior. One consequence of this way of thinking is that therapists who wish to rationalize their procedures as "scientific" have tended to perceive and describe their patients' behaviors as the product of external forces. Once a therapist proceeds on the assumption that the individual's adjusted or maladjusted behavior is determined by "external" forces, the thrust of therapy is presumably clear. Since the patient is the product of external forces, he is not to be blamed for his behavior but is to be understood. Therapy itself may have as its goal the attainment of
76
Journal of Religion and Health
understanding or "insight": Patients are to learn to acknowledge and accept {and perhaps submit to} that reality which constrains their actions and out of such a stoic alchemy learn to produce some measure of freedom. Alternatively, in the simple behavioral model, the environment must be modified to change the individual's behavior. The core inconsistencies of deterministic theories of therapy are obvious. Since all is determined by "outside" forces, it is less than clear how either the therapist or the patient can be regarded in any way as an active agent in the therapeutic process. Similarly, questions of accountability or responsibility are rendered meaningless. Historically, deterministic thinkers have attempted to respond to such problems. Theological thinkers like Paul, Augustine, and Calvin, when confronted with the patent injustice of an all-powerful God holding his determined creatures accountable for their unacceptable behaviors, thundered back variations on, "How dare you ask such a question?" In the more silent universe of Stoicism and the mechanistic world of science, blasphemy has no meaning and such a thunderous response no force. Instead, Stoics exempted the inner world of the individual from the more general determinisms and made the person responsible for the upkeep of his own house; one's attitude could be controlled even if one's future could not. But when the depth psychologies inhabited even this small space with intrapsychic determinisms, an internal arena of self-determination has become problematic, if not completely implausible, and therapists were in practice saved only by their inconsistencies. In behaviorism and classical psychoanalysis, therapists are summarily declared active agents by curiously being exempted from a universal process that binds the patient. The logic for such an exception is obscure, but the fact that such an exception is made is fortunate. The patient is less fortunate. It may comfort him to learn that his problematic behaviors are the products of powerful environmental or "disease processes" and that he is "not to blame" for them, but once he understands the "causes" for his behavior, what then? Once the notions of responsibility or accountability have been set aside for convenience' sake, it is hard to restore them meaningfully to the discussion. If the goal of therapy is to understand oneself, then to understand oneself as determined is a meaningful goal, although indeed the attainment of such an insight seems another curious exception in a deterministic universe. If the goal is change of some sort, the process is less clear. It could be that the attainment of insight will itself result in the disappearance of the unwanted behavior or feeling, much as a cancer shrivels in the presence of radiation; but the history of psychotherapy has given little ground for such a hope. More often the attainment of insight has been followed by renewed exhortations to behave as an active and responsible agent in determining the course of one's future life in a curious and sudden turn of events. Perhaps this was is the only way to the promised land, but experienced therapists see plenty of examples of patients who get lost and wander in the wilderness--patients who persist in behaving in unproductive
Richard C E n c k s o n
77
and self-destructive ways b u t who can elaborate at length on the psychosocial explanation for their state. It does little good to blame them for this; we, after all, are the ones who provided them with such deterministic rationales in the first place, and they presumably should not be faulted when we change horses in midstream. Of course, I would not want to deny the power of biological disease processes, whether pneumonia or diabetes or schizophrenia. I would argue, however, that it is a disservice to view any patient through the peephole of a diagnosis and to blame the disease (or environment} in order to exonerate the patient. Therapists usually find that this seductive short-run strategy is destructive in the long run. Hospitals are loaded with recidivists who solemnly explain, " I ' m Peter, and I am a paranoid schizophrenic," using such a declaration to exempt themselves from accountability for their behavior and responsibility for their lives. Time and again psychiatric staffs' deterministic illness explanations wear thin with time, and they seemingly have no alternatives to blaming the patient. The disease of diabetes m a y represent the most useful analogy. The patient has probably not caused certain biological imbalances b u t is still properly held accountable for how he manages them and for how he conducts himself in the community. There are always limiting cases, of course--usually fewer than we would like to a d m i t - - b u t the perception that an individual's behavior is determined by powerful foreign forces beyond his control is a treacherous one, not to be entertained lightly or for the sake of temporary convenience. Once lod~ed, deterministic exnlanations are difficult to dislodge..
Internal locus of control A second history declares that humans are the captains of their fate and masters of their souls, proposing that what happens is the consequence not of external forces b u t of one's own choices and actions. This explanation is congenial to many Americans but has seldom convinced reflective persons. Since the case for determinism has seemed overpowering, assertions of individual freedom and potency have usually maintained their force b y simply denying or ignoring the claims of the more deterministic systems. So it is that P e l a g i a n i s m and A r m i n i a n i s m have remained in the s h a d o w of Augustinianism and Calvinism, and that many existential philosophies from Kierkegaard to Sartre maintain themselves by a simple and stubborn denial of the personal relevance of Hegelian or scientific considerations. In all of this one does not sense that such philosophies or theologies have moved beyond the deterministic s y s t e m s that spawned them; one rather senses a stalemate. Third force or humanistic psychologies reflect the same dynamics in their reaction to the more deterministic psychodynamic or behavioral theories. The autonomy and self-determination of the individual are passionately asserted. The impact of environmental constraints is minimized or simply set aside as irrelevant to the therapeutic task. Self-determination is restored to the individual b u t not accountability. This happens for two reasons.
78
Journal of Religion and Health
First, the individuals are taught that they are responsible--but only to themselves. The goal of therapy in one form or another is "self-actualization." If anything, the demands of the community and environment are seen as forces that tend to induce one to live in inauthentic ways. Second, transcending values are obscured b y a pervasive relativism of values. The pluralism of modern society is taken to its logical extreme, and each individual is enjoined to declare total independence from all others and their expectations with, "I am I, and you are you . . . . ,,2 Such declarations of total independence prove intolerable, and we often witness such individualists submerging themselves in exotic value s y s t e m s {e.g., Eastern religions}, such exotic s y s t e m s supplying a new set of norms for the individual until their novelty wears off. Therapists operating in such a normless context are indeed in a quandary. They can represent no goals, because normative goals are not acknowledged; and they can exert no influence, because such influence is regarded as improper or impossible. Consequently, clients are confronted with therapists who deny that they direct or affect what happens {since they are nondirective) or deny they are therapists at all. Such denials represent either a tour de force of confusional technique or charlatanism; to be paid to contribute nothing and admitting so is surely a resourceful strategy. To be sure, such an experience m a y be entertaining, but the consumer takes it seriously at his peril, and reentry problems into the real world can prove catastrophic. These approaches have provided a diversion for the intelligent and successful for the most part; the poor and less fortunate are likely to view such approaches as merely fantastic.
A n alternative H o w is this stalemate to be resolved? The notion of "locus of control" defines the hinge on which the argument turns: Who or what is the effective agent responsible for an undesired behavior or experience? The problem has been given additional force by the societal assumption that someone or something must take the blame for the undesired behaviors. This judicial view informs our everyday transactions with one another. It is most graphically represented in the Judeo-Christian tradition by Old Testament sacrificial laws and by Anselm's satisfaction theory of the atonement. The therapeutic arena, it is argued, provides one place where an individual can acknowledge socially destructive and self-destructive ways of life and can work toward changing such behaviors without the fear of being blamed. That is commonly understood. B u t as therapists we m u s t take great care what grounds we use for withholding censure. Historically two grounds have been provided, as we have seen. The first denies that the person is the responsible agent, pointing instead to some form of external force. The second denies or ignores the reality of material and social constraints in the environment, making the individual answerable only to himself.
Richard C. E r i c k s o n
79
The problem is that reality demands both that the person be regardedfas an active agent and that the material and social environments be accorded constraining powers. Therapists who minimize or disregard either of these realities in the process of therapy risk resting their work on mythologies that they will sooner or later be forced to deny or qualify. Reality will inevitably insinuate itself. The therapeutic task demands that therapist and patient maintain clear c o m m i t m e n t s to the reality that each person is an active agent influencing and being influenced by the immediate and extended material and social environment. These commitments must pertain from the onset, and neither reality should fade nor be pushed out of focus for any appreciable time. Adler's approach, 3 Bandura's sophisticated behavior theory incorporating the notion of reciprocal influence, 4 and modern psychodynamic theorists like Arieti, ~ represent examples of this way to understanding the therapeutic task. Most of the great Catholic theologies from Irenaeus through Aquinas to modern times (including Roman, Anglican, Eastern, and Protestant middle-of-the-road theologies) maintain this proper tension. More recently, process philosophies and theologies 6 provide a fresh and more commodious vantage point, a vantange point that is consistent with current perspectives in the natural sciences. 7 Suppose now that the therapist or counselor sees himself and his client as holistic organisms creatively pursuing goals given value by the way each organism perceives the world within the constraints of a social environment (Adler) and t h a t this process continues to evolve over time (process thought). What are some implications for therapy? First, while the individual's behavior is like]y to be better understood given a knowledge of his history and environmental situation, it is unlikely to be the simple effect of the same. This is so because even in the simplest cases, current behavior is the product of an interaction between the individaul and his environment, not the simple function of the individual's environment (internal or external). Stated more concretely, all persons suffering the probable biochemical deficit contributing to a diagnosis of schizophrenia do not limp through life the same, nor do all children from broken homes or slum neighborhoods turn out the same. This unpredictability is a reflection of reality, not a reflection of our lack of knowledge of reality; our laws will always be statistically true, not mechanistically true, because of the nature of reality. To the determinist determined to " g e t to the bottom of things" this is frustrating, but to the therapist and his client it is reassuring: the task of change is not simple, but it is at least possible. Second, the reality of things is more complex than either the therapist or patient dared to hope or fear. There are m a n y examples of this. We realize the future is not a simple product of the past. We know the individual cannot proceed with simple disregard for his environment. To say a behavior is purposeful is not necessarily to say that it is done on purpose. To assert that we pursue goals we deny to awareness is not to assert that we can arrive at a state of total enlightenment. The question, "Which came first, the chicken or
80
Journal of Religion and Health
the egg?" has no answer. While problematic behaviors and schemes are rooted in past experiences and while their exposure and uprooting m a y lead to the solution of present problems, there is no guarantee future problems will be solved or obviated by present acts. One cannot arrive once and for all. ~ Third, the therapist is not above it all, b u t neither is he simply a fellow traveler on a journey across (criss-crossing?) an open field. This suggests the therapist can always be thrown off the track by patients' seductions. M o s t patients will sooner or later home in on the therapist's vulnerabilities; his persisting needs to be seen as "fair" or "powerful" or "understanding"or "responsive to the patient's feelings," and the like. This also implies the path we travel with our patients has physical and social boundaries. Concessions to autonomy or self-actualization have their limits. The physical and social environments do have boundaries which are no less real for being finally imprecise. The therapist is well advised to keep such contraints in the foreground of his perceptual field as well as that of his patient, lest both be seduced into the fiction that one can have things both ways. Natural or logical consequences do properly follow actions. Fourth, the therapist and the patient are responsible and accountable for their behaviors and subject to their consequences even if they are not blameworthy. The patient is not to be "demoralized" by being declared impotent by means of deterministic explanations. The same energies that contributed to the pursuit of mistaken goals can be placed at the service of socially useful and personally satisfying goals. At the same time, the experienced therapist is disinclined to censure the patient. A good deal of foolishness and very little perverseness exist in an individual's unsuccessful a t t e m p t s to address life's complex tasks. To understand is to credit the patient with resourcefulness given his perception of the demands of reality. So we respect the patient, a resourceful rascal who has " m a d e the best of it" under given perceptual and environmental circumstances. It is not easy to maintain such a posture. To grant the patient responsibility for his behavior (even "under the circumstances") is to hold him accountable and subject to consequences2 B u t to admit the patient is "accountable" is to risk the entrance of accountability's bastard brother "blame." As we have seen, however, efforts to exempt the patient from blame by depriving him of responsibility are too costly. We have no alternative b u t to effect a difficult therapeutic balancing act, proceeding with the skill of a Mohawk crossing a high girder in a buffeting wind. If we fail, our therapeutic enterprise will fall to its death upon the rocks of determinism or in the whirlpools of relativism and "autonomy." The more subtle thinking of St. Irenaeus is reassuring here. Perhaps our failings partake less of high drama than the Augustinian legend would suggest. Perhaps they are, after all, of the nature of mistakes and selfdeceptions made by the immature. Such mistakes and self-deceptions certainly make the journey unnecessarily complicated and difficult but not necessarily hopeless, precisely because we have never been left abandoned or unloved--or so the gospel story has it.
Richard C Erickson
81
References 1. Rotter, J.B., "Generalized Expectancies for Internal versus External Locus of Control of Reinforcement," Psychological Monographs General-Applied, 1966, 80, (1, Whole No. 609}, 1-28. 2. Perls, F., Geltalt Therapy Verbatim. Lafayette, California, Real People Press, 1969, p. 4. 3. Mosak, H., and Dreikurs, R., "Adlerian Psychology." In Corsini, R., ed., Current Psychotherapies. Itasca, Illinois, Peacock, 1973. 4. Bandura, A., "Behavior Theory and the Models of Man," American Psychologist, 1974, 29, 297-309. 5. Arieti, S., The Will to be Human. New York, Quandrangle, 1972. 6. Brown, D.; James, R.E.; and Reeves, G., eds., Process Philosophy and Christian Thought. Indianapolis, Bobbs-Merrill, 1971; Cobb, J.B., and Griffin, D.R., Process Theology: An Introductory. Exposition. 7. See Wolf, F.A., Taking the Quantum Leap. San Francisco, Harper & Row, 1981. Particularly helpful discussions of the relationship between science and religion in the post-Darwinian, post-Einsteinian era are to be found in the writings of Barbour, I.G., Issues in Science and Religion. New York, Harper & Row, 1966; and Myths, Models, and Paradigms. New York, Harper & Row, 1974; Peacocke, A.R., Science and the Christian Experiment. London, Oxford University Press, 1971; and Creation and the World of Science. Oxford, Oxford University Press, 1979. 8. Erickson, R., "The Vulnerable Hero: Theology and the Goals of Therapy," J. Religion and Health. 1973, 12, 328-336. 9. --, "Viewing the Therapeutic Community through Adlerian Spectacles," International J. Group Psychotherapy. In Press. 10. "Reconciling Christian Views of Sin and Human Growth with Humanistic Psychology," Christian Scholars Review, 1978, 8, 114-125. An excellent selection of St. Irenaeus's writing is to be found in Bettenson, H., ed., The Early Christian Fathers. London. Oxford University Press, 1969.
