Book Review: Standards and Ethics for Counselling in Action

In many respects, Tim Bond has done a great service to the counselling profession by writing, and now updating, this book. He is a former chairperson of the Standards and Ethics Committee of the British Association for Counselling (as it then was), which produced several editions of the Code of Ethics and Practice. He has recently been instrumental in producing the Ethical Framework for Good Practice in Counselling (2001) published by the BACP. He has clearly devoted a considerable amount of his professional life to working on these codes, and his book explains the principles that guided him.

His particular strength must surely be his clarity in acquainting counsellors with the complexities of British law. After an introduction, he starts with an exploration of the origins and scope of counselling. He then exemplifies cases in which a counsellor's personal and professional values collide. He has collected together a host of ethical dilemmas that counsellors might have to face. He has grouped dilemmas under subject-headings (such as safety, confidentiality — unfortunately he has not included a discussion of The New Informants (1995) — and record-keeping), and provided excellent vignettes to demonstrate how easily ethical dilemmas arise, and how complex many of them turn out to be. He then suggests several ethical guidelines which a counsellor might want to consider, and quotes any relevant sections of recent British law. This includes a fine reference to the Magna Carta. Some readers may be surprised to learn that British law does not, save in certain instances, require a counsellor to break confidentiality if the client threatens suicide.

Dr Bond does not usually recommend particular answers, but instead weighs up the ethical guidelines, and points out any obvious weaknesses or shortcomings. He refers to a ten-page bibliography at the end, so that readers can look up sources and locate further information. For those who are short of reading-time, he has provided a 'Conclusion' at the end of each chapter, in which he summarises his argument. In its nine years of publication, it must surely have provided information to many counsellors which they might not otherwise have known about.

'This book is intended to be practical,' writes Dr Bond, in his introduction. However, on a subject like ethics, it is difficult to see how its practice can be severed from the philosophy that informs it. One can see the weakness of Dr Bond's position in the chapters on 'Client Autonomy', followed by 'Suicide and Refusal to Accept Life-Saving Treatment'.

Without an explicit philosophy to clarify what he means by the autonomy of the client, Dr Bond is forced onto the fence, explaining both sides of an ethical dispute, rather than standing firm on client autonomy.

Dr Bond states: 'As counsellors, we are privileged to witness the moral struggles of our clients as they search for the right thing to do or for moral meaning in what is happening to them.' (2000: 51) This is well said, yet Dr Bond doesn't build on this observation. A counsellor is more than a witness to a client's moral search. The counsellor's relationship to the client who is searching is itself moral. Counselling is not a technical skill which can be practised within an ethical framework. The 'interior' of this ethical framework is itself ethical. Is this not a subject for a book on ethics for counselling?

Dr Bond asks counsellors the fundamental question: 'Why be ethical?' He supplies the brisk answer: 'Unless counselling is provided on an ethical basis, it ceases to serve any useful purpose.' 'Useful' is used here as a poor substitute for 'good'. Something 'useful' can only be identified by its useful result — though Dr Bond is silent on the interesting question as to who decides, and by what criteria, whether a counsellor's ethical action has proved 'useful'. Yet ethics stretches far beyond what is useful. Surely, the answer to Dr Bond's question, 'Why be ethical?', is that the client's 'moral struggles' are not incidental; they are what counselling is about. The very heart of authentic counselling is ethical. It is only the counsellor's own continuing experience of ethical striving, and some degree of clarity learned from it, that entitles a counsellor to offer to attempt to help the client struggle through moral confusion.

This recognition is honoured in the Hippocratic Oath of about 430 BC. Practitioners who took the Oath swore that: 'I will be chaste and religious in my life and in my practice.' Life and practice were recognised as closely connected. Shakespeare explored this theme in a discussion between two murderers, in King Richard III. The second murderer is all ready to commit a murder and pocket a large reward. Then, to his great regret, his conscience responds to '... a blushing shamefac'd spirit that mutines in a man's bosom.' In the end, he cannot commit the murder. 'Take thou the fee,' he tells the first murderer. Shakespeare makes it clear that conscience is not utilitarian. For a murderer, it is unprofessional. But its voice came from within 'a man's bosom', and the second murderer chose to heed it.

Dr Bond ends with an interesting section on what he coins 'ethical mindfulness'. This ending might make a good starting-point for a different kind of book. It is curious that not much on this subject has been published by the counsellors and psychotherapists who inherit the sensitive ethical thinking of Kierkegaard, Heidegger, Sartre and Levinas.

Existential philosophers have shown that being ethical means, not a series of separate ethical decisions, but a lifelong quest for understanding. We need to become aware of all those ways in which we avoid the discomfort of ethical recognition. Kierkegaard wrote that friends were likely to say: "Why take life so seriously? Cut out the straining, and we will live a beautiful, rich, and significant life in friendship and joy." (1962: 129-130) Vividly, he shows how much easier and more comfortable it would be to avoid recognising difficult truths. His focus, therefore, started with himself. He asked himself the same ethical question about the value of self-love that had occurred to Aristotle in The Nichomachean Ethics. His answer, however, is rooted in Judeo-Christian literature. He distinguished loving oneself, in the sense of recognising oneself as an equal to others, from superficial forms of self-love that get in the way of a person's ability to perceive others. 'To love oneself in the right way and to love one's neighbour correspond perfectly to one another,' he wrote; 'fundamentally they are one and the same thing.' (1962: 39)

This gives him a moral relationship to his neighbour. Kierkegaard was clear that ethics were of everyday importance. They did not simply show up over ethical dilemmas. Heidegger took this further. His perception was of persons born into relationships. He used the word 'care' to express Dasein's ongoing moral involvement with others. He saw how easy it was to lose the silent call of conscience in noise of 'idle talk'. 'The call... does not call him into the public chatter of the they, but calls him back from that to the reticence of his existent potentiality-of-being.' (1996: 255-56) But, like Kierkegaard, he recognised that understanding this call could be a struggle, and that Da-sein is able to misinterpret the call of conscience by manipulating and distorting it from its authentic meaning. Sartre developed some of Kierkegaard's and Heidegger's ideas with his concept of 'bad faith' to reveal how we distract ourselves from perceiving the reality of our situation. Brilliantly, he describes, not a confrontation or dilemma, but ordinary life in motion, such as his waiter in the café. Sartre could be much more specific than either Kierkegaard or Heidegger about the scope of moral involvement. 'If I am mobilised in a war, this war is my war; it is in my image and I deserve it,' he wrote. (1966: 708) Sartre claimed that Heidegger's notion of Mitsein denied the otherness of the other, and so was itself in bad faith. (1966: 335-6) Levinas also criticised Heidegger for, as he saw it, putting 'Being' before ethics. For Levinas, what is primary, before and beyond 'Being', is responsibility to and for the other. The primacy of the other's face is, he says, the commandment: 'Thou shalt not murder'. (1985) However, for all their subtle differences, these thinkers constitute a tradition of utmost relevance to the questions Dr Bond raises.

Dr Bond does briefly allude to Thomas Szasz's writing on suicide. (He also claims: 'R.D. Laing (1967) has argued that suicide is the ultimate right of any individual.' (2000: 97) But the book to which he refers, The Politics of Experience and The Bird of Paradise, nowhere argues this.) Yet Dr Bond doesn't do justice to Dr Szasz's starting-point. In The Ethics of Psychoanalysis, Dr Szasz states: 'Clearly, then, psychoanalysis is a moral exercise or, if one wishes to put it that way, a moral therapy. Because it deals with the nature and value of varying styles of personal conduct, it could not be anything else.' (1974: 202) He distinguishes between the 'autonomous' therapist and the 'heteronomous' one. 'A primary duty of the autonomous therapist is to take care of himself,... As I shall try to show, the client's aspirations towards autonomy can be facilitated by the therapist only if he conducts himself autonomously toward the patient.' (1974: 45) This embodies existential philosophy although, at that time, Dr Szasz defined himself as a psychoanalyst. From this truly existential position, Dr Szasz was able to criticise the work of 'the existential therapists', singling out a case study by Medard Boss, on the grounds that Boss was infantilising his patient. (1974: 112)

All these ideas seem to be unified in a short and remarkable paper, published in the second issue of this Journal. 'Orientation' was an eight-page lecture, given at Regent's College, by Aaron Esterson. 'Authentic existential counselling is also a moral enterprise, in my experience. There is no moral neutrality as in a medical or quasi-medical practice like psychiatry....' (1991: 18) He contrasts the authentic recognition of true right and true wrong with self-deceptions made in bad faith. He introduces a term, based on Sartre's, which deserves to enter everyday dialogue: 'existential good faith'. (1991: 19) Like Kierkegaard and Levinas, Esterson described the struggle to engage in authentic inter-relationships. Like Heidegger, he recognised that moral preoccupation was a return to 'one's true existential possibilities'. (1991: 19) In a similar way to Szasz, he recognised that counsellors were engaged in the journey towards wholeness, as their clients were. The paper ends with a brilliant exposition of how counselling can enable a client to change.

'Existentialism' gets no mention in Dr Bond's index. Existential writers, when one takes them together, have made a substantial contribution to our understanding of ethical relationships. This deserves wider recognition.

Naomi Stadlen

References

• Bollas, C. and Sundelson, D. (1995). The New Informants: Betrayal of Confidentiality in Psychoanalysis and Psychotherapy. London: Karnac.
• Esterson, A. (1991). Orientation. Journal of the Society for Existential Analysis, 2.
• Heidegger, M. (1996). Being and Time. State University of New York.
• Kierkegaard, S. (1962). Works of Love. London: Collins.
• Levinas, E. (1985). Ethics and Infinity. Pittsburgh: Duquense University Press.
• Sartre, J.-P. (1956). Being and Nothingness. New York: Pocket Books, Simon and Schuster.
• Szasz, T.S. (1974). The Ethics of Psychoanalysis. New York: Basic Books.