Choosing Sides

Eliminating bias is essential to counseling. Objectivity is the goal. Even more, it is the foundation of science, medicine, and the rational mind (supposedly?). According to this logic, the most capable counselor is a blank slate who may “put on” the private logic of a client and demonstrate how to negotiate the issues of reality. However, if a client’s broken logic yields an unfortunate outcome, how can a therapist operating from the same perspective yield any other result?

In 1960, E. M. Jellinek crowned his career with the publication of The Disease Concept of Alcoholism. Based on this influential work and the research that followed, the public’s perception of individuals with addictions changed from the morally corrupt to patients in need of a doctor. But the disease model doesn’t quite fit. For example, those with diseases are made victims against their will; while, true addicts desire to continue destructive behavior even when facing severe negative consequences.

Until recently, it appeared to me that a better alternative to the disease model was to view an addiction as entirely the result of one’s own choices. This perspective not only forced the addict to take responsibility, but it empowered the individual by ascribing the ability to make changes that will effectively change one’s present condition. Although an attractive theory, I believe it to be misled. The appeal of this view lies in its ability to explain a very complex problem (addiction) in a very simple way (choices – especially those that we control!!).  But, this view ignores both the ability of addictions to become enmeshed in a family system (codependency & enabling) and the power of the family system to assist in a recovery effort. I believe the core of this view rests on a questionable western concept of identity – a person is the total sum of what he or she chooses to be.

During a recent study of the apostle Paul, I observed contrasting beliefs of personal identity that existed in the 1st century Mediterranean world and today among dyadic cultures across the globe. In Paul’s world an individual was defined by the groups to which one belonged rather than one’s choices. Thus, Paul identified himself as “a Jew, born in Tarsus of Cilicia, but brought up in this city." His audience understood the weight an authoritative claim delivered by a man rooted in power. We might say that this view could cast addiction as a disorder of a system (the addicted family as opposed to the addicted individual).  Likewise, family systems models of therapy maintain that members of the system work to maintain the homeostasis of the system, even if it means maintaining destructive behavior. Therefore, the counselor must rehabilitate the family system and not solely the substance user.

I see in myself an identity composed of both choices and groups. For this reason, I wonder if the “objectivity” we pursue will ever yield the healing we desire. It isn’t as if the therapist must choose one side or the other (choices v. groups); its all the same side (I hear whispers of Paul’s voice in Eph 6:12). Thus, the most capable therapist may not be the blank slate, or even the therapist who has mastered the world, but the one who is always willing to learn.