Matthews’s Moral Vision

In his valuable contribution, Eric Matthews defends a careful and moderate thesis. I am in sympathy with his general conclusions and welcome his attempt to show the common ground between psychotherapy and moral education. There is, as his argument suggests, a moral dimension to some conditions commonly seen as treatable by psychiatrists and/or psychotherapists. But this moral dimension threatens neither psychotherapeutic nor ethical stances, in spite of the fact that many people see the two as being in tension. For example, some people believe that the helpfulness and sympathetic attitude expected of mental health professionals should include eschewing moral judgments about the behavior and attitudes of those in their care. Others, also suspecting that moral and psychotherapeutic approaches are in fundamental opposition, embrace the moral stance (e.g., toward drug addicts, sex offenders, and others who attract psychiatric attention) and for that reason reject the claims of mental health professionals to be able to treat them without expressing condemnation. However, as Matthews implicitly recognizes, both the “nonjudgmental” and the “bootstraps” stances are inadequate to answer the complex questions that arise. To understand some mental disorders, we need some ethical theory and a grasp of the conceptual relationships between the mentally healthy life and the morally admirable life. Plato is the famous progenitor of this idea, though he did not express it in those terms. It is in this spirit that Matthews conducts his enquiry.

Matthews’s approach, then, is one of reconciliation. There need be no opposition between the goals of psychotherapy and those of moral education. In fact, the best psychotherapy sometimes is moral education. The reconciliation is supported by Platonic and especially Aristotelian conceptions of the terrain of the ethical, as opposed to Kant’s emphasis on pure practical reason. While Kant felt he had to postulate a mysterious ‘noumenal’ world, set apart from the ‘phenomenal’ world of cause and effect, in order to show how moral motivation was possible, Aristotle made no such distinction. Good moral behavior was motivated by desire, just like any other behavior, though desire would lead one astray if it was not properly trained. Virtue was a state of character, consisting of a habit of desiring the right things. It is worth noting that in important ways Hume had the same idea, although he, like Kant, was both creature and one of the creators of the Enlightenment. Pace Matthews, this casts a little doubt on the strength of the connection between the ideas of the early modern period and the supposedly mistaken twentieth-century stress on what we do, as opposed to what we are, in delineating the sphere of ethical judgment. Hume was a determinist, in spite of his famous doctrine that we do not apprehend necessary connections between events, and he thought that desires caused action. Perhaps we should not lay too much stress on the contrast between pre- and post-scientific conceptions of agency.

We should also be careful not to overestimate the differences between Aristotelian and Kantian ideas about the sphere of the ethical. Matthews is right to mention important contrasts, but we should also concede some common ground. There is no reason why “act-centered” and “agent-centered” conceptions should always be at war. If we attach moral significance to “what we are,” this must be partly because of its implications about the things we characteristically do; and if we blame people for doing certain things, we do so at least partly because we take their actions to reflect something of their characteristic motives and desires. It is important to keep this in mind if we are not to weaken the concept of the normative so much that it has scarcely anything to do with morality at all. Matthews points out that depressed people, and others, suffer disorders of motivation; someone who is suicidally inclined has a desire that “falls short of certain generally accepted norms of how people ought to behave, and to desire to behave” (my italics). But then again, there is a sense in which the heart is meant to pump blood around the body, and the brain is...