The cogito circa AD 2000

What are we to make of the cogito (cogito ergo sum) today, as the walls of Cartesian philosophy crumble around us? The enduring foundation of the cogito is consciousness. It is in virtue of a particular phenomenological structure that an experience is conscious rather than unconscious. Drawing on an analysis of that structure, the cogito is given a new explication that synthesizes phenomenological, epistemological, logical, and ontological elements. What, then, is the structure of conscious thinking on which the cogito draws? What kind of certainty does the experience of thinking give one about one's thinking and about one's existence? What form of inference is the cogito, and what is the source of its validity and soundness? Does the cogito itself lead to an ontology of mind and body like Descartes's dualism? The discussion begins with Descartes's own careful formulations of some of these issues. Then the cogito is parsed into several different principles, the phenomenological principle emerging as basic. In due course the analysis sifts through Husserl's epistemology, Hintikka's logic (or pragmatics) of the cogito, and Kaplan's logic of demonstratives, as these bear specifically on the cogito.     

Fat-Oppressive Attitudes and the Feminist Therapist:

This article will examine the responses of other feminist therapists to the author's anti-fat-oppressive stance. These reactions will be used as a base from which to generate some hypotheses regarding the difficulties that continue to be faced by women therapists in attempts to identify and reduce internalized fat-oppressive attitudes regarding their own bodies and those of their women clients. Suggestions for heightening personal awareness regarding internalized fat oppression, and strategies for reducing fat-oppressive attitudes as a therapist will be presented.     

The Milan Approach,History, and Evolution

The two authors intend to underline the continuities and discontinuities that organize the Milan Approach, after the splitting from Selvini Palazzoli and Prata; they intend to tell the teachings of Luigi Boscolo and Gianfranco Cecchin from the beginning of training in 1978 till nowadays. After having spoken of some important stages in the work till the death of the two masters, the article underlines two major new aspects. 1. We speak about the corporeal turn: embodied experience as preconceptual know‐how from which concepts are structured. We speak about the connections between bodies and social issues that enact forms of knowledge and understanding. 2. In this period of war, violence, and tyranny, we speak about epistemology and ontology as complementary stances: the need to let others disclose themselves, by allowing them to speak their own terms of engagement. The therapeutic effort is one of deactivating the dangers of one’s own presuppositions and prejudices that limit one’s capacity to describe and make hypothesis. There are social ontologies, communities with strong moral intensity, historical and social realities that need therapists to take position, since they need to take side and be aware of the categories they utilize. Historical and social ontology deals with the continuous change of symptoms in connection to the continuous change of the social panorama in the context we live in. We live by the bodies we are.     

REASONS AND REASON REVISITED: ANOTHER REPLY TO MORRISON

In a previous article, Katherine Morrison (1999) argued that in my book Back to Reality: A Critique of Postmodern Theory in Psychotherapy (Held, 1995) I failed to accept the "strictly epistemological" aim of the narrative therapy movement. In the present article she reiterates the same objections, and adds the new criticism that I perceive epistemological oscillations in the writings of narrative therapists where there are none. In my present response I summarize my prior response to Morrison's (1999) critique (Held, 1999a), and I then respond to her new objections by showing how the conflation between epistemology and ontology that she attributes to me reflects her own confusion rather than mine.     

Listening to Both Sides of the Therapeutic Dyad: Self-Disclosure of Gay Male Therapists and Reflections From Their Gay Male Clients

Clinicians vary as to their beliefs about the use of self-disclosure in psychotherapy depending on theoretical framework, experience level, and the problem focus. Given the limited number of studies examining therapeutic pairs (client and clinician), this study used qualitative methodology to interview gay male therapists and their gay male clients about how therapist self-disclosures affected their therapy. Results show that clients often felt aware of therapist self-disclosures, whether explicit or implicit, and believed the disclosures assisted them in feeling connected to their therapists and served to normalize the clients’ experiences. Limitations to the study are discussed.     

Révéler son humanité ? L’autorévélation du thérapeute à la lumière de la recherche empirique

Self-disclosure, which consists in revealing personal information about oneself to one's client, could be a beneficial therapeutic technique. There are yet many definitions of this concept. However, empirical research shows that self-disclosure may be favourably perceived by clients and that it could influence how they perceive their therapist. Moreover, it could positively influence treatment outcome. Self-disclosure about immediate feelings in the therapy and about the therapist–client relationship would be particularly effective in resolving problematic events by enabling feelings to be expressed and accepted and by providing clients with interpersonnal learning. Several authors finally advise using this technique infrequently, about moderately intimate but relevant themes in relation to the therapy, examining each client's specific needs, and always with the intention of helping them or improving the therapeutic relationship.     

Counseling Counselors: A Survey of Values

This study surveyed counselors' rates of involvement in counseling, explored whether counselors value seeing therapists of a similar theoretical orientation to their own, and examined which characteristics were important in choosing one's therapist. Of 2,000 randomly selected ACA members, with a 38% return rate, 80% were found to have attended counseling, with women seeking counseling at significantly higher rates than men. Having been in counseling varied as a function of division affiliation as well as counselor's theoretical orientation. Finally, this study also explored the characteristics deemed important in choosing one's counselor and the values counselors hold regarding involvement in their own therapy.     

Cultural ruptures in short‐term therapy: Working alliance as a mediator between clients' perceptions of microaggressions and therapy outcomes

Aim: To determine whether or not clients' perceptions of microaggressions varied based on their own and the therapist's race/ethnicity and whether or not they would be negatively related to the effectiveness of therapy and if the working alliance would mediate this effect. Method: The study utilised a cross‐sectional, retrospective, methodology. Clients were recruited from a large university counselling centre in the United States (N=232 clients and 29 therapists). Results: Neither clients' race/ethnicity, therapists’ race/ethnicity, nor client‐therapist ethnic matching predicted perceptions of microaggressions. Clients' ratings of microaggressions were negatively associated with their psychological wellbeing; however, this effect was mediated by clients' ratings of the working alliance. Implications: Therapists should take into account the cultural messages they may be conveying to both white and racial/ethnic minority clients. Therapists should develop strategies that are consistent with a general therapeutic approach that promotes discussions about culture with their clients and, most importantly, should attend to the therapeutic relationship.     

Bodily Awareness, Imagination and the Self

Common wisdom tells us that we have five senses: sight, hearing, smell, taste and touch. These senses provide us with a means of gaining information concerning objects in the world around us, including our own bodies. But in addition to these five senses, each of us is aware of our own body in ways in which we are aware of no other thing. These ways include our awareness of the position, orientation, movement, and size of our limbs (proprioception and kinaesthesia), our sense of balance, and our awareness of bodily sensations such as pains, tickles, and sensations of pressure or temperature. We can group these together under the title ‘bodily awareness’. The legitimacy of grouping together these ways of gaining information is shown by the fact that they are unified phenomenologically; they provide the subject with an awareness of his or her body ‘from the inside’. Bodily awareness is an awareness of our own bodies from within. This perspective on our own bodies does not, cannot, vary. As Merleau‐Ponty writes, ‘my own body…is always presented to me from the same angle’ (1962: 90). It has recently been claimed by a number of philosophers that, in bodily awareness, one is not simply aware of one's body as one's body, but one is aware of one's body as oneself. That is, when I attend to the object of bodily awareness I am presented not just with my body, but with my ‘bodily self’. The contention of the present paper is that such a view is misguided. In the first section I clarify just what is at issue here. In the remainder of the paper I present an argument, based on two claims about the nature of the imagination, against the view that the bodily self is presented in bodily awareness. Section two defends the dependency thesis; a claim about the relation between perception and sensory imagination. Section three defends a certain view about our capacity to imagine being other people. Section four presents the main argument against the bodily self awareness view and section five addresses some objections.     

The Epistemological Problem of Other Minds and the Knowledge Asymmetry

The traditional epistemological problem of other minds seeks to answer the following question: how can we know someone else's mental states? The problem is often taken to be generated by a fundamental asymmetry in the means of knowledge. In my own case, I can know directly what I think and feel. This sort of self‐knowledge is epistemically direct in the sense of being non‐inferential and non‐observational. My knowledge of other minds, however, is thought to lack these epistemic features. So what is the basic source of my knowledge of other minds if I know my mind in such a way that I cannot know the minds of others? The aim of this paper is to clarify and assess the pivotal role that the asymmetry in respect of knowledge plays within a broadly inferentialist approach to the epistemological problem of other minds. The received dogma has always been to endorse the asymmetry for conceptual reasons and to insist that the idea of knowing someone else's mental life in the same way as one knows one's own mind is a complete non‐starter. Against this, I aim to show that it is at best a contingent matter that creatures such as us cannot know other minds just as we know a good deal of our own minds and also that the idea of having someone else's mind in one's own introspective reach is not obviously self‐contradictory. So the dogma needs to be revisited. As a result, the dialectical position of those inferentialists who believe that we know about someone else's mentality in virtue of an analogical inference will be reinforced.     

Morality is Not Like Mathematics: The Weakness of the Math‐Moral Analogy

In both the early modern period and in contemporary debates, philosophers have argued that there are analogies between mathematics and morality that imply that the ontology and epistemology of morality are crucially similar to the ontology and epistemology of mathematics. I describe arguments for the math‐moral analogy in four early modern philosophers (Locke, Cudworth, Clarke, and Balguy) and in three contemporary philosophers (Clarke‐Doane, Peacocke, and Roberts). I argue that these arguments fail to establish important ontological and epistemological similarities between morality and mathematics. There are analogies between the two areas, but the disanalogies are more significant, undermining the attempt to confer on morality the same ontological and epistemological status that mathematics possesses.     

Death of a Clinician: The Personal, Practical and Clinical Implications of Therapist Mortality

Death is inevitable and yet in US culture the discussion of death is somewhat taboo. Marriage and Family therapists are trained in the implications of grief and loss for clients who lose loved ones and yet examination of the impact of therapist mortality on clients is lacking in the clinical literature. This article examines ways that private practice therapists can both protect their client’s confidentiality and mitigate the impact of therapist sudden death on their clients with planning and forethought. In addition, the factors influencing the lack of empirical research on this topic is discussed in the context of social mores on death and how therapists’ own denial of mortality may impact their ability to connect with clients through the pain of grief and loss. Recommendations are made for therapists to evaluate their own attitudes towards mortality and develop a plan for client care in the event of their death.     

‘Coming out’ in therapy? Perceived risks and benefits of self‐disclosure of sexual orientation by gay and lesbian therapists to straight clients

Primary objective: The study's primary objective was to investigate the experiences of gay and lesbian therapists, when considering self‐disclosure of their sexual orientation to straight (i.e. heterosexual) clients. This qualitative study set out to ascertain the key factors gay therapists take into account when considering this decision and to explore the effects this self‐disclosure may have on themselves, their clients and their therapeutic relationships. Research design: The research design was based on the use of semi‐structured interviews, undertaken with a non‐random, purposive sample of counsellors and psychotherapists (n=8) in current practice. The rationale for this method was to aid exploration of therapists' experiences of the process of self‐disclosure. Methods and procedures: Inclusion criteria were for therapists who self‐identified as being gay or lesbian, and who were experienced in clinical work with straight clients. Transcribed data was analysed using inductive thematic analysis. Main outcomes and results: Some therapists reported being confident with self‐disclosure relating to their own sexual orientation. However, a common theme related to the reportedly high levels of anxiety and vulnerability, which therapists identified. Key themes emerged around: respondents' fears of client judgement; a need for therapist self‐protection; self‐awareness of the potential impact of their own fears and prejudices on the therapeutic relationship; and the potential relevance of internalised homophobia, as an overall constraining factor. Conclusions: Self‐disclosure of their sexual orientation to straight clients is constructed, in this initial survey, as being potentially problematic and risky for some gay therapists.     

Transparency and self-disclosure in family therapy: dangers and possibilities

Therapy is a paid intimate relationship that thrusts clients and therapists into navigating personal and professional boundaries. When, where, why, and how is it appropriate and ethical for family therapists to be transparent, and when is it damaging? Theorists take varied stances from Haley's position of tight boundaries around therapist disclosure—whether in treatment or training—to the narrative viewpoint that therapists should be transparent about models of therapy, personal values, and life experiences that inform their practice and beliefs. However, these positions are not research based, and theorists who support disclosure offer few guidelines other than general statements. This article examines the history of ideas about disclosure in six major family therapy models, and the dangers and possibilities of transparency. It looks at the research on self‐disclosure in individual therapy and whether and how it could apply to family therapy. Guidelines are proposed that take into account the multiple social identities of therapists and clients, and issues of safety and transparency.     

The family as its own reflecting team: a family therapy method

Social research has suggested that people, in general, tend to overestimate their skills and abilities. Interestingly, research has found that peers are better predictors of a person's behaviour than self‐assessment, suggesting that others know us better than we know ourselves. Family therapists should be aware that family members might not give accurate accounts of themselves. In order to overcome this problem, therapists should incorporate peer assessments into therapy. Reflecting teams and videotaping do incorporate peer assessments, yet these methods can be impractical. This article describes a method of family therapy using enactments as a means of setting up the family as its own reflecting team. The method suggests that the family and therapist switch roles several times during the enactment, and then encourages a discussion on the peer observations on how each person addresses a problem in the family. Case examples illustrate how feedback from peers promotes insights.     

Therapist Perceptions of Client Reactions

This study examined therapist ability to identify client-reported reactions. Sixteen therapists each saw two volunteer clients for single counseling sessions. In postsession reviews, clients rated the helpfulness of, and indicated their reactions to, each therapist intervention. Therapists also rated the helpfulness of, and indicated their perceptions of client reactions to, each therapist intervention. In 50% of the instances therapists matched clients, that is, reported the same reaction cluster as the clients did. There were higher match rates on the reaction clusters of therapeutic work (62%), supported (54%), and no reaction (46%) than negative reaction (27%) and challenged (14%). When therapists matched on therapeutic work, helpfulness ratings for the following intervention were higher than when therapists did not match. In contrast, when therapists matched on negative reactions and no reaction, helpfulness ratings for the following intervention were lower than when they had not matched. Thus, therapists' ability to match client reactions was related to their ability to generate helpful interventions. Implications for practice and future research are discussed.     

Client concealment and self-presentation in therapy: comment on Kelly (2000)

The authors disagree with A. E. Kelly's (2000) conclusions that clients conceal things from therapists primarily for self-presentational reasons and that client concealment is positively related to positive therapy process and outcome. They also disagree with A. E. Kelly regarding the implications of self-presentation theory for therapy. Their review of the research suggests that clients do not conceal much from therapists, that what they do conceal involves many different kinds of information hidden for many different reasons, that therapists have wide variability in being able to detect hidden client material, and that the relationship of client concealment and therapist awareness of client concealment with therapy process and outcome is not clear. Finally, the authors discuss their views about implications of client concealment and self-presentation for therapy.     

Love in therapy: A qualitative study of how clients perceive their therapists’ emotions

Relevant literature on attachment theory has explored the importance of emotional experience inside the therapeutic setting, highlighting that the active engagement of the therapist with the client is necessary in the process of change. However, less is known about the clients’ perception of the therapists’ emotional expression during a session. In this qualitative study, we used narrative thematic analysis to examine 10 semi-structured interviews with clients in an enriched systemic therapy approach. Focusing on the similarities of clients’ experiences, what emerged from the interviews were specific ‘perceived emotions’ and the related facial expressions of the therapists that were given attention by the clients. Based on our findings, six emotional themes were identified and are considered prominent: (i) ‘excitement’, (ii) ‘calmness’, (iii) ‘affection’, (iv) ‘empathy’, (v) ‘anger’ and (vi) ‘sadness’. Also, the analysis revealed two distinct functions of the expression of the therapist’s emotions: (i) they are an essential part of the therapeutic relationship and, (ii) they provide clients with alternative ways of experiencing emotions and motivate them to change. Therapists are invited to recognize the importance of their own emotional and facial expression in therapy considering it a form of self-disclosure. Suggestions for further research are also provided.     

How do you see me? Coming out in counselling

Recent large-scale survey research has raised serious concerns in both the counselling community and the mass media about the ways in which counsellors work with lesbian, gay and bisexual (LGB) clients. The current questionnaire-based research focused on client experiences of their own, and their counsellor's, self-disclosures of sexuality. Most clients did not require counsellor disclosure. However, failure of the counsellor to disclose could result in problems and assumptions being made by the client. We conclude that LGB awareness is improving, but there is still much need for training in this area to challenge limiting assumptions by some counsellors and to avoid the need for clients to educate them.