ROBERT
W. DALY
Values: a view from the clinic IN" THE PREFACEtO his famous Gifford Lectures, William James wrote: " . . . a large acquaintance with particulars often makes us wiser than the possession of abstract formulas. ''I It is the clinician's fate to be acquainted with numerous particulars, eases, or more correctly with persons in the midst of their dis-orders and dis-eases; and it is his task to elaborate an efficacious response, or at the very least to "do no harm" to those who consult him. It is when he is doing with others--in his activity as a purveyor of services--that he encounters beliefs and values and learns of the variety of ways in which these elements of human personality become arranged within the life processes of individual persons. His work, however, requires the moderate use of "abstract formulas," for the practitioner cannot survive for long if he imagines himself to be confronted at every moment by an absolute anarchy of stimuli, phenomena, and events. Particulars, to be even remotely intelligible, must be formulated. W e know that the theorist-practitioners of the past and of our own time have not hesitated to formulate the place of believing and beliefs, valuing and values in their efforts to understand themselves and their fellow-men. There are at least two reasons for this fact: i. Beliefs and values have enormous implications for human action. 2. These components of experience and action cannot be physiologized, psychologized, sociologized, philosophized, or for that mattcr, psychoanalyzed away. These elements of personality continue to present themselves in a relatively clear and irreducible fashion in the life processes of most persons. With notable exceptions,2 however, it has remained a curious fact that those familiar with clinical work have generally been reluctant to designate beliefs and values per se as critical variables in the life processes of the individual. It is true that the moral, technical, and institutional This paper is a revision of an essay read at the Annual Meeting of the Society for the Scientific Study of Religion held in New York City on October 30, x965. 126
Journal of Religion and Health
questions involved are complex, that the scientific status of such investigations has been questioned, 8 and that the lexicon of the practitioner has tended to obscure rather than to reveal this element of human action and experience. Nonetheless, the central contention of this essay is that beliefs and believing, values and valuing are of fundamental importance in determining the actions of individual persons. Therefore, the clinical canon of psychiatry and psychoanalysis should contain formal guidelines or "abstract formulas" that will enable the practitioner to describe a person's values in the context of his life processes. Because of practical considerations, I shall be able to develop only a segment of this proposition-that relating values and valuing to the actions of the individual person. To this end, I shall first introduce a schema for the clinical investigation of the value component of human action and experience. Secondly, I intend to explore three of the di~eulties encountered when values and valuing are taken to be variables sui generis in the life processes of the human organism. These difficulties are: the nature of the relationship between action and value meaning, the fact that human personality is always becoming, and the simultaneous relationship of human values to explanations and to justifications. Valuing and human action There are two principal modes in which values are commonly represented in the actions of a given person. The first consists of those explicit combinations of thought and feeling concerning those symbolic ends that are pursued, and those actions that are undertaken to bring about a desired end. The second mode consists of those symbolic ends that are inexplicitly sought by a given person, and of the components of action that are undertaken in the service of these ends. It is to either or both of these modes of valuing that we refer when speaking of the value meaning of human activities. While it frequently proves to be an inordinately difficult task to assess the extent to which human actions bear the mark of conscious reflection and choice, the clinician finds he does participate in making such perilous assessments if he is convinced that valuing is a prominent activity of the human organism. I shall not struggle here with this special problem4mnor shall I discuss the place of values and valuing in the integrative and adaptive processes of the person;5 their function in defining human health, disValues: a viev: from the clinic
12 7
order, and treatment; ~ or their position with respect to the "other parts" of the organism, v There are additional areas of inquiry concerning values, action, and personality which continue to warrant attention. These topics include the genesis of values in relation to anxiety, objects, and the exigencies of the life cycle; 8 their relationship to eulture and to social, political, and economic processes; the actual and the potential forms of value-meaning; their internal compatibility and incompatibility; and the oft-noted ineongruence in the life of the person, between his value definitions and his behavior. All of these and many other pertinent topics regarding values are beyond the scope of this paper) Our goal is to identify the basic terms requisite for any clinical discussion of values and valuing. The following terms and definitions are suggested as a practical vocabulary wkh which to describe the value component of human action as it appears in the clinical situation. 1~ Value definition denotes the symbolic ends per se and should be distinguished from value explication, a term used to designate the plan, technique, or means for representing "the good" (or "the evil"). Value representation refers to the action(s) or "the act(s)" that bears value meaning. Value con~ormation (a judgment) implies acceptable or successful representation in action of a desired symbolic value. Value deviance (another judgment) denotes the failure of action to represent identifiable and/or acceptable value definitions. An example shows how this schema is used: "It is good to love this woman (definition or end), and I will greet her with affection (explication or means). My activities such as bringing flowers and kissing (value representations) have expressed my love (conformation)." Judgments regarding deviance and conformity can be made by others as well as by the person who acts--e.g., "His activities mean that he loves me." A fragment of clinical activity will serve as a more complete illustration of the use of this schema. It will also introduce a hint of the formal complexities of a clinical study of values--an effort that involves the activities of at least two persons. Mr. Jones, after consultation with his internist, decides to seek the assistance of a psychiatrist. With some anxiety he tells the practitioner that he has been troubled by the thought of killing his wife, whom he also claims to love. Following a question regarding other features of his current life, Mr. Jones suddenly becomes angry and begins to complain in bitter x 28
Journal of Religion and Health
tones, "My wife is against m e . . . the neighbors are talking about m e . . . this is a Communist p l o t . . , you are going to kill m e . . . " The psychiatrist may think, "This man is not testing reality very well. There are no Communists plotting against him, and he admits that he has no reason to kill his wife; certainly his anger is not an appropriate response to the communications I have made to him. This behavior of his is a manifestation of a personality dis-integration. Perhaps his defenses have weakened. I shall be more circumspect in my conversation with h i m . . . " The psychiatrist then emits a cautious, "Oh?" If we now apply the vocabulary suggested above to the reflections and activities of the psychiatrist, it is obvious that the patient's actions have been judged to be deviant. The sudden anger, the thoughts about the wife and the plot could be identified as that which is said to be deviant. A second feature to note is that a value definition prescribed for Mr. Jones by the practitioner (and perhaps espoused by the patient as well) has not been represented in action Mr. Jones should "test reality (value definition or desired end)." T w o items appear to be required whenever value deviance or conformity is predicated of the activities of a person (by himself or others).11 These are: (a) what is claimed to be deviant or conforming --some form of human activity, and (b) that symbolic end from which (a) is deviant or that symbolic end to which (a) conforms--an end of some specifiable sort. Clinicians characteristically render value representations in terms of some observable phenomena--communications, verbal or nonverbal, etc.; and render value definitions in terms of desirable symbolic ends--"reality testing," "ego strength," "work and love," etc. If it is granted that such a vocabulary is sufficient to distinguish the bare outlines of the [acts concerning the relation of action to value and of acting to valuing, we may proceed to inquire about certain stumbling blocks which must be recognized and met if this schema is used in the clinical setting.
Three difficulties Actions and meaning. The clinician has a most difficult task in discerning the relationships that obtain between the actions and symbolic intentions of an individual person. If he continues to learn about the activities of his patient, he finds out that actions frequently do not "speak for themselves." For a given person, the same action may have a variety Values: a view from the clinic
xz 9
of, and even opposite, symbolic value meanings. Conversely, a single value definition may be manifested in a great number of disparate actions. TM It is necessary to begin the investigation of the idiodynamie patterning of values anew with each patient in order to specify the manifold relations that obtain between value definitions (ends) and value representations (actions). It would be incorrect, however, to imply that the clinical investigation of valuing is nothing but an exereise in radical empiricism. There are generalizations concerning human personality that enable us to understand how actions and symbolic value definitions beeome fused and often appear in an orderly and repeatable fashion. But even if we are prepared to meet the patient with "viewpoints" regarding human personality, and with specific knowledge of the patient's place in the life eycle, his history, hopes, and current circumstances, and if we have some knowledge of our own proclivities, inclinations, and limitations in the clinical setting, we are frequently hard pressed to give a fully convincing and complete account of the relations that obtain at any given time between actions and value meanings. 1~ This difficulty alone should indicate that clinical judgments about the value meaning of the patient's actions and declarations of deviance and conformity are at best inferential and ascriptive judgments. Change and time. If the contingent status of the relationship between value representations (actions) and value definitions (ends) is recognized, a second impediment is then found in the way of gaining complete knowledge of the patient's values and his processes of valuing. The human organism is always becoming. 14 He exists in a dynamic, open, incomplete, and unfinalized condition. 15The relationships between actions and symbolic values change with time in response to a range of factors that continue to defy comprehensive codification. While the contingent relationships between actions and values frustrate attempts to determine the organization (and/or disorganization) of value meaning at any given time, the dynamic and historical aspects of a personality reveal that the processes of valuing have various durations. Some values and processes of valuing "last a lifetime" and others are as brief as the time required to move to one's next thought. Not only can values and the modes of valuing change in time, but also in time, the arrangement of those values that endure can change so that they have a different "position" in the organizational pattern of the personality. TM Freud's 130
Journal of Religion and Health
admonitions to suspend final judgment and to assume an "even hovering attitude" toward the patient's productions are well taken. Explanations and justifications. There is a third problem in attempting to use the proposed schema to describe the values of a given patient. If it is recognized that the terms value definition (end), explication (means), and representation (action) help to specify and order the value component of action and experience; and that the terms conformity and deviance are items of judgment concerned with the affirmation or denial of the acceptability of value-meaningful action, we are still confronted by this question: What terms are used to establish and maintain connections between actions and meanings? What reasons are given for the association of an action with a symbolic value or for the association of a value definition with a specific act? In the contemporary clinical setting, two kinds of terms are continually and simultaneously encountered. The first set of terms has to do with explanations; the second with justifications. Explanations unite actions and values by "telling why" value-meaningful events occur as they do. Justifications fuse actions and values by "making right" or "declaring good" the value-meaningful events that do occur. It is pertinent to examine the distinction between explanations and justifications in some detail because this distinction and its implications are often neglected or confused in the practical affairs of the clinic, despite the fact that in modern times these two terms are considered to have different sources and denotations. The following discussion of explanations and justifications is intended to stipulate the more obvious implications of these two ways of accounting for value-meaningful actions, iv W e shall return to the interview between Mr. Jones and the psychiatrist and continue to focus on the activities and experiences of the practitioner in order to illustrate this third difficuky in the clinical study of persons and values.
Explanations: It will be recalled that a portion of the patient's behavior was judged deviant. The psychiatrist could establish no reasonable, acceptable, or even identifiable connection between the patient's verbal and affeetive behavior ("kill wife," "a Communist plot," the sudden anger), and the values and processes of valuing that the patient was expected to represent in action. The deviant activity was codified as indicative of a "fail-
Values: a vie~v from the clinic
131
ure to test reality," and then explained by means of the concepts imbedded in the phrase, "weakening defenses." The idea of weakening defenses established a connection between the patient's remarkable actions and the question of symbolic meaning when it appeared that the usual connections and associations between actions and meanings had been lost. Explanations purport "to tell why." Our interest here is not in the adequacy of such explanations. The purpose of picturing an ordinary clinical explanation is to call to mind several characteristics of this kind of reasoning, which functions, in part, to help the practitioner comprehend value-meaningful action. For instance, we can observe that the need for explanations appears most compellingly and with the greatest frequency when the relationship between action and meaning is most obscure; that is, when a person's action is not, or cannot be, comprehended by the standards that define justifiable conduct. On such occasions a great variety of atomistic and holistic explanations can be brought forth to account for the situation. These accounts usually have to do with one aspect of the personality of the individual. His actions are not viewed as being wholly the result of "his own doing," rather, they are seen as the result(s) of the workings of part-processes of the personalized organism over which the organism, as maker of his own action, has little control. The person is undergoing something. Radical conceptualizations, such as the unconscious, TM conditioned responses, 19 and the concept of temperament, 2~ are examples of clinical explanations. A second feature of clinical explanations is that they are used not only to tell why a person's value-meaningful action is of a certain sort, but also to furnish implications for the practitioner's own activity with the patient. At times it is possible to trace the same set of ideas from their use as explanations of the patient's behavior to their use as iustifications for the clinician's behavior. For example, a clinician who acts to produce convulsions in a certain patient may attempt to justify his activity by explaining why the patient is severely depressed. Taken by themselves, these accounts do not constitute justifying reasons for the clinician's conduct, for they say nothing about what makes his valuemeaningful action good or right. It is only as the clinician gives a moral or forensic account of his action that he justifies (or fails to justify) it. Unfortunately, it is only possible to cite this distinction. W e cannot discuss its many implications and dilemmas---both practical and specu13 2
Journal of Religion and Health
lative--that confront the clinician in his day-to-day activities. It suffices if it is clear that in contemporary practice clinical explanations are often and unknowingly made to serve a double duty: to explain the patient's action, and to justify the conduct of the practitioner. Justifications:
The other major theme found in the reasons given for the association of symbolic definitions of value with specific actions has to do with justifications. A justification declares a human action "good." A justification makes a person's meaningful behavior "right;" and at the same time, may be a reason, in the sense of an explanation, for value-meaningful action. In other words, the justification that is given for an action may not only declare it right, but may also constitute one answer to the question "why." The explanation for a value-meaningful action can simply be that the action is undertaken to implement a defined symbolic purpose congruent with the person's view of "the good." Extensions of the psychiatrist's interview with Mr. Jones will illustrate this second variety of reason-giving. The psychiatrist asks Mr. Jones, a successful auto dealer, about his business aetivites. The patient, who has regained his initial composure, apologizes for his prior outburst and enthusiastically begins to recount his techniques for selling ears. In the course of his remarks he says that, "Selling ears is a great way to get to know people," and that, "I have been able to support my wife and kids in pretty good style these past few years." If we apply the schema outlined under Valuing and human action, it may be said that Mr. Jones subscribed to the value definitions, "It is good to know people" and "It is desirable to support one's wife and family." Suppose that after a long analysis it appeared that Mr. Jones's business activities v:ere in meaningful conformity with his value definitions. T o the extent that the patient's value-meaningful actions are what he claims them to be and are related to his view of reality and the good, in one sense these actions and experiences are explained because they are intelligibly justified. On such occasions the person per se is usually seen as the author of his action and the preceptor of his values. It would greatly simplify our task if the reasons that made actions and symbolic value definitions "stick together" or "come apart" were dearly related in each ease to the realm of either explanations or justifications. But even a modicum of experience in the clinical setting rules Values: a view f r o m the clinic
x 33
out such a speculation as the means for resolving this third difficulty, For example, clinicians and patients have discovered that justifying deelarations can be used in a self-deceiving way. At such times the giving of justifications may be comprehended by recourse to explanations of the type discussed above; justifications are frequently used in the service of defense against inexplicit fears, wishes, and impulses. In summary, this difficulty does not disappear in the light of existing psychoanalytic or psychiatric theories and practices. Clinicians, at their best, keep an open mind about the nature of the bonds that bind action and value meaning in any given ease. Either explanation or justification or both are conceived to be possible reasons for the value-meaningful activity of both parties to a clinical relationship. It is apparent that the clinical, historical, and philosophical questions concerning the relationships of explanations and justifications in human affairs have not been fully answered. The relation between explanations for value-meaningful action (the unconscious, conditional responses, etc.) and the environing doctrines (revealed truths, ethics, laws, etc.) that declare actions justified or unjustified by virtue of their incorporation into the life processes of persons continue to merit study by scholars familiar wkh the realities of clinical work and the range of circumstances essential to the welfare of the human organism. 21 Conclusion
The purpose of this paper was to suggest the basic terms of a schema for the description of the values and the processes of valuing of the individual person and to explore three difficulties that stand in the path of satisfactory description. To return to the spirit of James, I recognize that this essay is short on facts and evidences, but I have supposed that the reader already has an adequate "acquaintance with particulars" with which to judge the utility of these several "abstract formulas." REFERENCES
I. James, William, The Varieties of Religious Experience. New York, Mentor Books, i958, p. ix. 2. The examples eked here indicate the range of contemporary exceptions. Allport, Gordon W.; Vernon, P. E.; and Lindzey, G., A Study of Values, 3rd edition. Boston, Houghton Mifflin, I96o. Allport, Becoming. New Haven, Yale University Press, I955, pp. 75-78. Angyal, Andras, Foundations for a Science of Personality. Cambridge, Harvard University Press, ~958, Chap. V. x 34
Journal of Religion and Health
3. 4. 5. 6. 7. 8.
Ansbacher, H., and Ansbacher, R., The Individual Psychology of Alfred Adler. New York, Basic Books, 1956, pp. 64-69, I35. Buhler, Charlotte, Values in Psychotherapy. New York, The Free Press of Glencoe, I96z. Glad, Donald G., Operational Values in Psychotherapy. New York, Oxford University Press, ~959. Hartmann, Heinz, Psychoanalysis and Moral Values. New York, International Universities Press, 196o. , The Ego and the Problem of Adaptation. New York, International Universities Press, I958, Chaps. 6 and 7. Maslow, Abraham, Toward a Psychology of Being. New York, D. Van Nostrand Co., I962, pp. 141-174. Moral Values in Psychoanalysis. Proceedings of the Sixth Academy Symposium (I963) of the Academy of Religion and Mental Health. New York, Academy of Religion and Mental Health, 1965. Morris, Charles, Varieties of Human Value. Chicago, University of Chicago Press, i956. Smith, M. Brewster, et al., Opinions and Personality. New York, John Wiley & Sons, I959 (Science Editions, 1964). For a scholarly review and appraisal of Freud's contribution to the study of human valuing, see Rieff, Philip, Freud: The Mind of the Moralist. New York, Anchor Books, 196I. Ryle, Gilbert, The Concept of Mind. London, Hutchinson's University Library, I949. See Peters, R. S., The Concept of Motivation. London, Roudedge & Kegan Paul, 1958, Chap. 3. Hartmann, op. cir. Daly, Robert W., Concepts for the Social Studies: A Contribution from Medicine. Unpublished manuscript, Social Studies Curriculum Center, Maxwell School of Citizenship, Syracuse University. See also Glad, op. cir. Angyal, op. cir. Erikson, Erik H., "Identity and the Life Cycle," Psychological Issues, I959,
(1). 9- Three reviews of current literature on values can be found in Jacob, P. E.; Flink, James J.; and Schachman, H. L., "Values and Their Function in Decision Making," Supplement to The American Behavioral Scientist, r962, z (9); Smith, B. M., "Personal Values in the Study of Lives." In White, R. W., ed., The Study of Lives. New York, Prentice-Hall, i963, pp. 324-347; MeLaughlin, B., S.J., "Values in Behavioral Science," ]. of Religion and Health, 1965, 4, 258-279. For a review of the clinical literature, see Buhler, op. cir. Io. Experience with patients and the general nature of clinical work are not the only forces that shape clinical perspectives. The suggestions in this essay rest, in the first instance, on many of the implications of the Freudian organon. In addition, I have been influenced by the phylogenetie view of human values offered by Irving Hallowell (Culture and Experience. Philadelphia, Univ. of Pennsylvania Press, '955, see esp. Chap. 2o; "Self, Society, and Culture in Phylogenetic Perspective." In Tax, Sol, ed., The Evolution of Man. Chicago, Univ. of Chicago Press, 196o), the precise explication of the formal nature of symbolic functioning offered by Leslie White ("Four States in the Evolution of Minding." In The Evolution of Man), the logical coherence found in the "modeling" of beliefs, values, and actions by Edward Tolman ("A Psychological Model." In Parsons, Taleott, and Shils, Edward A., eds., Toward a General Theory of Action. Cambridge, Harvard Univ. Press, I951), the immediately useful and scientific formulations of values and valuing by Clyde Kluckhohn and others ("Values and Value Orientations in the Theory of Action." In Toward a General Theory of Action), and the illuminating research in a social context by Otto yon Meting (A Grammar of Human Values. Pittsburgh, Univ. of Pittsburgh Press, i96, ). Values: a view f r o m the clinic
~3
xi. Illustrative material can be found in Glad, op, cir., esp. Chap. VIII. xz. See also Allport, Gordon W., Pattern and Growth in Personality. New York, Holt, Rinehart and Winston, I96r, pp. 345-347, 373-375; and Rapaport, David, "The Structure of Psychoanalytic Theory," Psychological Issues, i96o , e (z), 3o-3i. x3. In the psychoanalytic situation it is the patient who has the responsibility for determining what his value-meaningful actions shall be. W e are speaking of the clinician's difficulty in understanding the determinations that are made by the patient. I4. Allport, Becoming, op. cit. tS. Angyal, op. cir. I6. Ibid., Chaps. 8, 9, xo. x7. See Peters, op. cit., for a more philosophical view of these distinctions. i8. Freud, Sigmund, "The Unconscious" (I915). Trans. by Cecil M. Baines. Collected Papers, Vol. IV. London, Hogarth Press, Ltd., i925. I9. Dollard, John, and Miller, Neal E., Personality and Psychotherapy. New York, McGraw-Hill Book Co., x95o. 2o. Sheldon, H., The Varieties of Temperament. New York, Harper & Bros., I942 9 2I. For such a study, see Nelson, Beniamin, "Self-Images and Systems of Spiritual Direction in the History of Western Civilization." In Klausner, S. Z., ~d.,
The Quest for Self-Control: Classical Philosophies and Scientific Research. Glencoe, Free Press, 1965, pp. 4o-xo3.
136
Journal of Religion and Health
W. DALY
Values: a view from the clinic IN" THE PREFACEtO his famous Gifford Lectures, William James wrote: " . . . a large acquaintance with particulars often makes us wiser than the possession of abstract formulas. ''I It is the clinician's fate to be acquainted with numerous particulars, eases, or more correctly with persons in the midst of their dis-orders and dis-eases; and it is his task to elaborate an efficacious response, or at the very least to "do no harm" to those who consult him. It is when he is doing with others--in his activity as a purveyor of services--that he encounters beliefs and values and learns of the variety of ways in which these elements of human personality become arranged within the life processes of individual persons. His work, however, requires the moderate use of "abstract formulas," for the practitioner cannot survive for long if he imagines himself to be confronted at every moment by an absolute anarchy of stimuli, phenomena, and events. Particulars, to be even remotely intelligible, must be formulated. W e know that the theorist-practitioners of the past and of our own time have not hesitated to formulate the place of believing and beliefs, valuing and values in their efforts to understand themselves and their fellow-men. There are at least two reasons for this fact: i. Beliefs and values have enormous implications for human action. 2. These components of experience and action cannot be physiologized, psychologized, sociologized, philosophized, or for that mattcr, psychoanalyzed away. These elements of personality continue to present themselves in a relatively clear and irreducible fashion in the life processes of most persons. With notable exceptions,2 however, it has remained a curious fact that those familiar with clinical work have generally been reluctant to designate beliefs and values per se as critical variables in the life processes of the individual. It is true that the moral, technical, and institutional This paper is a revision of an essay read at the Annual Meeting of the Society for the Scientific Study of Religion held in New York City on October 30, x965. 126
Journal of Religion and Health
questions involved are complex, that the scientific status of such investigations has been questioned, 8 and that the lexicon of the practitioner has tended to obscure rather than to reveal this element of human action and experience. Nonetheless, the central contention of this essay is that beliefs and believing, values and valuing are of fundamental importance in determining the actions of individual persons. Therefore, the clinical canon of psychiatry and psychoanalysis should contain formal guidelines or "abstract formulas" that will enable the practitioner to describe a person's values in the context of his life processes. Because of practical considerations, I shall be able to develop only a segment of this proposition-that relating values and valuing to the actions of the individual person. To this end, I shall first introduce a schema for the clinical investigation of the value component of human action and experience. Secondly, I intend to explore three of the di~eulties encountered when values and valuing are taken to be variables sui generis in the life processes of the human organism. These difficulties are: the nature of the relationship between action and value meaning, the fact that human personality is always becoming, and the simultaneous relationship of human values to explanations and to justifications. Valuing and human action There are two principal modes in which values are commonly represented in the actions of a given person. The first consists of those explicit combinations of thought and feeling concerning those symbolic ends that are pursued, and those actions that are undertaken to bring about a desired end. The second mode consists of those symbolic ends that are inexplicitly sought by a given person, and of the components of action that are undertaken in the service of these ends. It is to either or both of these modes of valuing that we refer when speaking of the value meaning of human activities. While it frequently proves to be an inordinately difficult task to assess the extent to which human actions bear the mark of conscious reflection and choice, the clinician finds he does participate in making such perilous assessments if he is convinced that valuing is a prominent activity of the human organism. I shall not struggle here with this special problem4mnor shall I discuss the place of values and valuing in the integrative and adaptive processes of the person;5 their function in defining human health, disValues: a viev: from the clinic
12 7
order, and treatment; ~ or their position with respect to the "other parts" of the organism, v There are additional areas of inquiry concerning values, action, and personality which continue to warrant attention. These topics include the genesis of values in relation to anxiety, objects, and the exigencies of the life cycle; 8 their relationship to eulture and to social, political, and economic processes; the actual and the potential forms of value-meaning; their internal compatibility and incompatibility; and the oft-noted ineongruence in the life of the person, between his value definitions and his behavior. All of these and many other pertinent topics regarding values are beyond the scope of this paper) Our goal is to identify the basic terms requisite for any clinical discussion of values and valuing. The following terms and definitions are suggested as a practical vocabulary wkh which to describe the value component of human action as it appears in the clinical situation. 1~ Value definition denotes the symbolic ends per se and should be distinguished from value explication, a term used to designate the plan, technique, or means for representing "the good" (or "the evil"). Value representation refers to the action(s) or "the act(s)" that bears value meaning. Value con~ormation (a judgment) implies acceptable or successful representation in action of a desired symbolic value. Value deviance (another judgment) denotes the failure of action to represent identifiable and/or acceptable value definitions. An example shows how this schema is used: "It is good to love this woman (definition or end), and I will greet her with affection (explication or means). My activities such as bringing flowers and kissing (value representations) have expressed my love (conformation)." Judgments regarding deviance and conformity can be made by others as well as by the person who acts--e.g., "His activities mean that he loves me." A fragment of clinical activity will serve as a more complete illustration of the use of this schema. It will also introduce a hint of the formal complexities of a clinical study of values--an effort that involves the activities of at least two persons. Mr. Jones, after consultation with his internist, decides to seek the assistance of a psychiatrist. With some anxiety he tells the practitioner that he has been troubled by the thought of killing his wife, whom he also claims to love. Following a question regarding other features of his current life, Mr. Jones suddenly becomes angry and begins to complain in bitter x 28
Journal of Religion and Health
tones, "My wife is against m e . . . the neighbors are talking about m e . . . this is a Communist p l o t . . , you are going to kill m e . . . " The psychiatrist may think, "This man is not testing reality very well. There are no Communists plotting against him, and he admits that he has no reason to kill his wife; certainly his anger is not an appropriate response to the communications I have made to him. This behavior of his is a manifestation of a personality dis-integration. Perhaps his defenses have weakened. I shall be more circumspect in my conversation with h i m . . . " The psychiatrist then emits a cautious, "Oh?" If we now apply the vocabulary suggested above to the reflections and activities of the psychiatrist, it is obvious that the patient's actions have been judged to be deviant. The sudden anger, the thoughts about the wife and the plot could be identified as that which is said to be deviant. A second feature to note is that a value definition prescribed for Mr. Jones by the practitioner (and perhaps espoused by the patient as well) has not been represented in action Mr. Jones should "test reality (value definition or desired end)." T w o items appear to be required whenever value deviance or conformity is predicated of the activities of a person (by himself or others).11 These are: (a) what is claimed to be deviant or conforming --some form of human activity, and (b) that symbolic end from which (a) is deviant or that symbolic end to which (a) conforms--an end of some specifiable sort. Clinicians characteristically render value representations in terms of some observable phenomena--communications, verbal or nonverbal, etc.; and render value definitions in terms of desirable symbolic ends--"reality testing," "ego strength," "work and love," etc. If it is granted that such a vocabulary is sufficient to distinguish the bare outlines of the [acts concerning the relation of action to value and of acting to valuing, we may proceed to inquire about certain stumbling blocks which must be recognized and met if this schema is used in the clinical setting.
Three difficulties Actions and meaning. The clinician has a most difficult task in discerning the relationships that obtain between the actions and symbolic intentions of an individual person. If he continues to learn about the activities of his patient, he finds out that actions frequently do not "speak for themselves." For a given person, the same action may have a variety Values: a view from the clinic
xz 9
of, and even opposite, symbolic value meanings. Conversely, a single value definition may be manifested in a great number of disparate actions. TM It is necessary to begin the investigation of the idiodynamie patterning of values anew with each patient in order to specify the manifold relations that obtain between value definitions (ends) and value representations (actions). It would be incorrect, however, to imply that the clinical investigation of valuing is nothing but an exereise in radical empiricism. There are generalizations concerning human personality that enable us to understand how actions and symbolic value definitions beeome fused and often appear in an orderly and repeatable fashion. But even if we are prepared to meet the patient with "viewpoints" regarding human personality, and with specific knowledge of the patient's place in the life eycle, his history, hopes, and current circumstances, and if we have some knowledge of our own proclivities, inclinations, and limitations in the clinical setting, we are frequently hard pressed to give a fully convincing and complete account of the relations that obtain at any given time between actions and value meanings. 1~ This difficulty alone should indicate that clinical judgments about the value meaning of the patient's actions and declarations of deviance and conformity are at best inferential and ascriptive judgments. Change and time. If the contingent status of the relationship between value representations (actions) and value definitions (ends) is recognized, a second impediment is then found in the way of gaining complete knowledge of the patient's values and his processes of valuing. The human organism is always becoming. 14 He exists in a dynamic, open, incomplete, and unfinalized condition. 15The relationships between actions and symbolic values change with time in response to a range of factors that continue to defy comprehensive codification. While the contingent relationships between actions and values frustrate attempts to determine the organization (and/or disorganization) of value meaning at any given time, the dynamic and historical aspects of a personality reveal that the processes of valuing have various durations. Some values and processes of valuing "last a lifetime" and others are as brief as the time required to move to one's next thought. Not only can values and the modes of valuing change in time, but also in time, the arrangement of those values that endure can change so that they have a different "position" in the organizational pattern of the personality. TM Freud's 130
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admonitions to suspend final judgment and to assume an "even hovering attitude" toward the patient's productions are well taken. Explanations and justifications. There is a third problem in attempting to use the proposed schema to describe the values of a given patient. If it is recognized that the terms value definition (end), explication (means), and representation (action) help to specify and order the value component of action and experience; and that the terms conformity and deviance are items of judgment concerned with the affirmation or denial of the acceptability of value-meaningful action, we are still confronted by this question: What terms are used to establish and maintain connections between actions and meanings? What reasons are given for the association of an action with a symbolic value or for the association of a value definition with a specific act? In the contemporary clinical setting, two kinds of terms are continually and simultaneously encountered. The first set of terms has to do with explanations; the second with justifications. Explanations unite actions and values by "telling why" value-meaningful events occur as they do. Justifications fuse actions and values by "making right" or "declaring good" the value-meaningful events that do occur. It is pertinent to examine the distinction between explanations and justifications in some detail because this distinction and its implications are often neglected or confused in the practical affairs of the clinic, despite the fact that in modern times these two terms are considered to have different sources and denotations. The following discussion of explanations and justifications is intended to stipulate the more obvious implications of these two ways of accounting for value-meaningful actions, iv W e shall return to the interview between Mr. Jones and the psychiatrist and continue to focus on the activities and experiences of the practitioner in order to illustrate this third difficuky in the clinical study of persons and values.
Explanations: It will be recalled that a portion of the patient's behavior was judged deviant. The psychiatrist could establish no reasonable, acceptable, or even identifiable connection between the patient's verbal and affeetive behavior ("kill wife," "a Communist plot," the sudden anger), and the values and processes of valuing that the patient was expected to represent in action. The deviant activity was codified as indicative of a "fail-
Values: a vie~v from the clinic
131
ure to test reality," and then explained by means of the concepts imbedded in the phrase, "weakening defenses." The idea of weakening defenses established a connection between the patient's remarkable actions and the question of symbolic meaning when it appeared that the usual connections and associations between actions and meanings had been lost. Explanations purport "to tell why." Our interest here is not in the adequacy of such explanations. The purpose of picturing an ordinary clinical explanation is to call to mind several characteristics of this kind of reasoning, which functions, in part, to help the practitioner comprehend value-meaningful action. For instance, we can observe that the need for explanations appears most compellingly and with the greatest frequency when the relationship between action and meaning is most obscure; that is, when a person's action is not, or cannot be, comprehended by the standards that define justifiable conduct. On such occasions a great variety of atomistic and holistic explanations can be brought forth to account for the situation. These accounts usually have to do with one aspect of the personality of the individual. His actions are not viewed as being wholly the result of "his own doing," rather, they are seen as the result(s) of the workings of part-processes of the personalized organism over which the organism, as maker of his own action, has little control. The person is undergoing something. Radical conceptualizations, such as the unconscious, TM conditioned responses, 19 and the concept of temperament, 2~ are examples of clinical explanations. A second feature of clinical explanations is that they are used not only to tell why a person's value-meaningful action is of a certain sort, but also to furnish implications for the practitioner's own activity with the patient. At times it is possible to trace the same set of ideas from their use as explanations of the patient's behavior to their use as iustifications for the clinician's behavior. For example, a clinician who acts to produce convulsions in a certain patient may attempt to justify his activity by explaining why the patient is severely depressed. Taken by themselves, these accounts do not constitute justifying reasons for the clinician's conduct, for they say nothing about what makes his valuemeaningful action good or right. It is only as the clinician gives a moral or forensic account of his action that he justifies (or fails to justify) it. Unfortunately, it is only possible to cite this distinction. W e cannot discuss its many implications and dilemmas---both practical and specu13 2
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lative--that confront the clinician in his day-to-day activities. It suffices if it is clear that in contemporary practice clinical explanations are often and unknowingly made to serve a double duty: to explain the patient's action, and to justify the conduct of the practitioner. Justifications:
The other major theme found in the reasons given for the association of symbolic definitions of value with specific actions has to do with justifications. A justification declares a human action "good." A justification makes a person's meaningful behavior "right;" and at the same time, may be a reason, in the sense of an explanation, for value-meaningful action. In other words, the justification that is given for an action may not only declare it right, but may also constitute one answer to the question "why." The explanation for a value-meaningful action can simply be that the action is undertaken to implement a defined symbolic purpose congruent with the person's view of "the good." Extensions of the psychiatrist's interview with Mr. Jones will illustrate this second variety of reason-giving. The psychiatrist asks Mr. Jones, a successful auto dealer, about his business aetivites. The patient, who has regained his initial composure, apologizes for his prior outburst and enthusiastically begins to recount his techniques for selling ears. In the course of his remarks he says that, "Selling ears is a great way to get to know people," and that, "I have been able to support my wife and kids in pretty good style these past few years." If we apply the schema outlined under Valuing and human action, it may be said that Mr. Jones subscribed to the value definitions, "It is good to know people" and "It is desirable to support one's wife and family." Suppose that after a long analysis it appeared that Mr. Jones's business activities v:ere in meaningful conformity with his value definitions. T o the extent that the patient's value-meaningful actions are what he claims them to be and are related to his view of reality and the good, in one sense these actions and experiences are explained because they are intelligibly justified. On such occasions the person per se is usually seen as the author of his action and the preceptor of his values. It would greatly simplify our task if the reasons that made actions and symbolic value definitions "stick together" or "come apart" were dearly related in each ease to the realm of either explanations or justifications. But even a modicum of experience in the clinical setting rules Values: a view f r o m the clinic
x 33
out such a speculation as the means for resolving this third difficulty, For example, clinicians and patients have discovered that justifying deelarations can be used in a self-deceiving way. At such times the giving of justifications may be comprehended by recourse to explanations of the type discussed above; justifications are frequently used in the service of defense against inexplicit fears, wishes, and impulses. In summary, this difficulty does not disappear in the light of existing psychoanalytic or psychiatric theories and practices. Clinicians, at their best, keep an open mind about the nature of the bonds that bind action and value meaning in any given ease. Either explanation or justification or both are conceived to be possible reasons for the value-meaningful activity of both parties to a clinical relationship. It is apparent that the clinical, historical, and philosophical questions concerning the relationships of explanations and justifications in human affairs have not been fully answered. The relation between explanations for value-meaningful action (the unconscious, conditional responses, etc.) and the environing doctrines (revealed truths, ethics, laws, etc.) that declare actions justified or unjustified by virtue of their incorporation into the life processes of persons continue to merit study by scholars familiar wkh the realities of clinical work and the range of circumstances essential to the welfare of the human organism. 21 Conclusion
The purpose of this paper was to suggest the basic terms of a schema for the description of the values and the processes of valuing of the individual person and to explore three difficulties that stand in the path of satisfactory description. To return to the spirit of James, I recognize that this essay is short on facts and evidences, but I have supposed that the reader already has an adequate "acquaintance with particulars" with which to judge the utility of these several "abstract formulas." REFERENCES
I. James, William, The Varieties of Religious Experience. New York, Mentor Books, i958, p. ix. 2. The examples eked here indicate the range of contemporary exceptions. Allport, Gordon W.; Vernon, P. E.; and Lindzey, G., A Study of Values, 3rd edition. Boston, Houghton Mifflin, I96o. Allport, Becoming. New Haven, Yale University Press, I955, pp. 75-78. Angyal, Andras, Foundations for a Science of Personality. Cambridge, Harvard University Press, ~958, Chap. V. x 34
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3. 4. 5. 6. 7. 8.
Ansbacher, H., and Ansbacher, R., The Individual Psychology of Alfred Adler. New York, Basic Books, 1956, pp. 64-69, I35. Buhler, Charlotte, Values in Psychotherapy. New York, The Free Press of Glencoe, I96z. Glad, Donald G., Operational Values in Psychotherapy. New York, Oxford University Press, ~959. Hartmann, Heinz, Psychoanalysis and Moral Values. New York, International Universities Press, 196o. , The Ego and the Problem of Adaptation. New York, International Universities Press, I958, Chaps. 6 and 7. Maslow, Abraham, Toward a Psychology of Being. New York, D. Van Nostrand Co., I962, pp. 141-174. Moral Values in Psychoanalysis. Proceedings of the Sixth Academy Symposium (I963) of the Academy of Religion and Mental Health. New York, Academy of Religion and Mental Health, 1965. Morris, Charles, Varieties of Human Value. Chicago, University of Chicago Press, i956. Smith, M. Brewster, et al., Opinions and Personality. New York, John Wiley & Sons, I959 (Science Editions, 1964). For a scholarly review and appraisal of Freud's contribution to the study of human valuing, see Rieff, Philip, Freud: The Mind of the Moralist. New York, Anchor Books, 196I. Ryle, Gilbert, The Concept of Mind. London, Hutchinson's University Library, I949. See Peters, R. S., The Concept of Motivation. London, Roudedge & Kegan Paul, 1958, Chap. 3. Hartmann, op. cir. Daly, Robert W., Concepts for the Social Studies: A Contribution from Medicine. Unpublished manuscript, Social Studies Curriculum Center, Maxwell School of Citizenship, Syracuse University. See also Glad, op. cir. Angyal, op. cir. Erikson, Erik H., "Identity and the Life Cycle," Psychological Issues, I959,
(1). 9- Three reviews of current literature on values can be found in Jacob, P. E.; Flink, James J.; and Schachman, H. L., "Values and Their Function in Decision Making," Supplement to The American Behavioral Scientist, r962, z (9); Smith, B. M., "Personal Values in the Study of Lives." In White, R. W., ed., The Study of Lives. New York, Prentice-Hall, i963, pp. 324-347; MeLaughlin, B., S.J., "Values in Behavioral Science," ]. of Religion and Health, 1965, 4, 258-279. For a review of the clinical literature, see Buhler, op. cir. Io. Experience with patients and the general nature of clinical work are not the only forces that shape clinical perspectives. The suggestions in this essay rest, in the first instance, on many of the implications of the Freudian organon. In addition, I have been influenced by the phylogenetie view of human values offered by Irving Hallowell (Culture and Experience. Philadelphia, Univ. of Pennsylvania Press, '955, see esp. Chap. 2o; "Self, Society, and Culture in Phylogenetic Perspective." In Tax, Sol, ed., The Evolution of Man. Chicago, Univ. of Chicago Press, 196o), the precise explication of the formal nature of symbolic functioning offered by Leslie White ("Four States in the Evolution of Minding." In The Evolution of Man), the logical coherence found in the "modeling" of beliefs, values, and actions by Edward Tolman ("A Psychological Model." In Parsons, Taleott, and Shils, Edward A., eds., Toward a General Theory of Action. Cambridge, Harvard Univ. Press, I951), the immediately useful and scientific formulations of values and valuing by Clyde Kluckhohn and others ("Values and Value Orientations in the Theory of Action." In Toward a General Theory of Action), and the illuminating research in a social context by Otto yon Meting (A Grammar of Human Values. Pittsburgh, Univ. of Pittsburgh Press, i96, ). Values: a view f r o m the clinic
~3
xi. Illustrative material can be found in Glad, op, cir., esp. Chap. VIII. xz. See also Allport, Gordon W., Pattern and Growth in Personality. New York, Holt, Rinehart and Winston, I96r, pp. 345-347, 373-375; and Rapaport, David, "The Structure of Psychoanalytic Theory," Psychological Issues, i96o , e (z), 3o-3i. x3. In the psychoanalytic situation it is the patient who has the responsibility for determining what his value-meaningful actions shall be. W e are speaking of the clinician's difficulty in understanding the determinations that are made by the patient. I4. Allport, Becoming, op. cit. tS. Angyal, op. cir. I6. Ibid., Chaps. 8, 9, xo. x7. See Peters, op. cit., for a more philosophical view of these distinctions. i8. Freud, Sigmund, "The Unconscious" (I915). Trans. by Cecil M. Baines. Collected Papers, Vol. IV. London, Hogarth Press, Ltd., i925. I9. Dollard, John, and Miller, Neal E., Personality and Psychotherapy. New York, McGraw-Hill Book Co., x95o. 2o. Sheldon, H., The Varieties of Temperament. New York, Harper & Bros., I942 9 2I. For such a study, see Nelson, Beniamin, "Self-Images and Systems of Spiritual Direction in the History of Western Civilization." In Klausner, S. Z., ~d.,
The Quest for Self-Control: Classical Philosophies and Scientific Research. Glencoe, Free Press, 1965, pp. 4o-xo3.
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