Response to "Are Trustworthiness and Fairness Enough? Contextual Family Therapy and the Good Family"
Boszormenyi-Nagy, Ivan, Journal of Marital and Family Therapy
I was glad to accept Douglas Sprenkle's offer to respond to this article even though, as the reader will see, I disagree with many of the opinions expressed by its authors (I base my response on a draft of the article presented to me without the actual authors' names). The reason for my interest is my valuing any effort at discussing relational ethics as a courageous endeavor, even when this leads to erroneous conclusions.
It was Helm Stierlin, now of Heidelberg and then of Washington, DC, who, as a critical reader of Invisible Loyalties, commented on my approach (1972) and stated that it would need at least 10 years before the field of therapy would be ready to understand the importance of relational ethics: Classical family therapists used to see a Freudian orientation in my approach, and Freudian analysts tried to categorize my ideas as moralizing and misunderstood filial loyalty as crippling for the child.
Twenty-five years after Helm Stierlin's comments, I can see that people still struggle to grasp the leading concepts of my approach. I welcome the opportunity that has been given to me by the editor of the JMFT to discuss some common misconceptions about relational ethics and contextual therapy.
The origins of contextual therapy go back to my life-long search for an effective therapy of mental dysfunctions, including schizophrenia. Both a review of the literature on intensive individual psychotherapy and my empirical search for effectiveness criteria in my clinical work led me to the discovery of the importance of trust, first in the therapeutic relationship and later in family relationships. From there the road to the conceptual chain of trustworthiness, justice, fairness, and ethics was essentially an empirical search and not a philosophical, psychological, religious, or epistemological investigation.
The term ethics can be confusing and may lead to a conceptual departure into a value ethic of moralizing and judgmental type. Hence come the notions of value systems as criteria of merit, whereas contextual therapy has developed a merit criterion based on an interpersonal, relational foundation. Giving and receiving between persons and, ultimately, between a person and mankind as a whole, constitute the essence of relational ethics.
Cognitive efforts at defining ethical values are only tangentially relevant to the requirements of contextual therapy and relational ethics. This ethics concerns the dialectic of responsible caring within the relational dialogue rather than a cognitive consensus between partners. In this sense the interpersonal balance of fairness involves the subjectivity of two sides, each being anchored in the polarity of the respective self-interest of the two partners.
This critique's insistence on cognitive solutions to what moral positions should be are intellectually appealing and important, and its ideas about what a family should be are interesting but they don't as such lead to clinical relevance whether or not they claim ethical value.
I would like to make a similar comment about the clinical example discussed: It pertains much more to a description of the marital decision-making process on practical issues rather than to the discussions of matters that would have a direct ethical relevance. In addition, the authors state that according to the contextual approach, "The only good in family life is trustworthy relations." Where does this come from?
The authors of the critique share a common misunderstanding about the goal of contextual therapy, assuming that it claims a capacity for restoring and preserving justice among family members. This grandiose claim is neither made in my writings nor, fortunately, expected from any school of therapy. There are good reasons for the therapist to limit his or her therapeutic goals to the family members' own definition of their individual needs and claims to fairness and to avoid asserting a knowledge of what is "the good in family life. …