The Virtues in Psychiatric Practice

297 Pages·2022·11.852 MB·English

by  John R. Peteet

The Virtues in Psychiatric Practice

The Virtues
in Psychiatric
Practice
Edited by
JOHN R. PETEET
1
3
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Library of Congress Cataloging-i n- Publication Data
Names: Peteet, John R., 1947– editor.
Title: The virtues in psychiatric practice / [edited by] John R. Peteet.
Description: New York, NY : Oxford University Press, [2022] |
Includes bibliographical references and index. | Identifiers: LCCN 2021034905 (print) |
LCCN 2021034906 (ebook) | ISBN 9780197524480 (paperback) |
ISBN 9780197524503 (epub) | ISBN 9780197524510 (online)
Subjects: MESH: Virtues | Psychiatry | Social Responsibility |
Interpersonal Relations | Psychotherapy
Classification: LCC RC 480 . 5 (print) | LCC RC 480 . 5 (ebook) |
NLM WM 21 | DDC 616 . 89/ 14— dc23
LC record available at https://l ccn.loc.gov/ 2021034905
LC ebook record available at https://l ccn.loc.gov/ 2021034906
DOI: 10.1093/ med/ 9780197524480.001.0001
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Printed by Marquis, Canada
Contents
Preface vii
Contributors ix
Introduction 1
John R. Peteet
VIRTUES OF SELF- CONTROL
1. Accountability 17
Charlotte V. O. Witvliet and John R. Peteet
2. Humility 33
Nicholas D. Covaleski
3. Equanimity 61
Michael R. Tom and David R. Vago
VIRTUES OF BENEVOLENCE
4. Forgiveness 87
Everett L. Worthington Jr.
5. Compassion 109
Paul Gilbert
6. Love 129
John R. Peteet
VIRTUES OF POSITIVITY
7. Defiance 147
Nancy Nyquist Potter
vi Contents
8. Phronesis (Practical Wisdom) 165
Jerome Kroll and Perry C. Mason
9. Gratitude 185
Lilian Jans- Beken
10. Self- Transcendence 205
C. Robert Cloninger and Kevin M. Cloninger
11. Hope (Optimism, Resilience) 231
Warren Kinghorn
FUTURE DIRECTIONS
12. The Science of Human Flourishing 255
Tyler J. VanderWeele
Index 273
Preface
There is growing recognition of the value dimension of psychiatric
practice [1] , the contributions of positive psychology in documenting
the role of virtues in human flourishing [2], and the relevance to pro-
fessionalism of virtue ethics [3]. Books by Pellegrino and Thomasma
[4], and Sadler and Radden [5] have articulated virtues important
for medical practice and the psychiatric clinician, respectively. Duff
Waring [6] and others [7,8] have gone further to describe a place for
therapeutic virtues in psychotherapy understood as the cultivation of
character. A number of authors [9–1 2] have suggested that one’s pref-
erence for particular virtues depends on one’s worldview.
Even so, the place of virtues in psychiatric treatment remains largely
unexplored. How does a need for virtues fit into the processes of diag-
nosis, formulation, and treatment? What patient problems and other
factors should influence the therapist to promote forgiveness, grati-
tude, humility, or accountability? What is the relationship between the
therapist’s and the patient’s virtues? What is the relevance of religious
or spiritual resources to the formation of virtue? How does the culti-
vation of a particular virtue relate to psychodynamic, behavioral, ex-
istential, or spiritual approaches? What ethical questions does it raise,
and what are its implications for psychiatric education?
Following an Introduction containing a general framework for
approaching these questions, the chapter authors consider them in
relation to the theoretical and empirical literature, and discuss the
practical clinical implications of specific virtues, using case examples.
Building on a growing literature relating the Big Five personality traits
to character strengths and human functioning, the book considers
four basic capacities— self- control, benevolence, intelligence, and pos-
itivity— roughly corresponding to the four cardinal virtues of Plato
and Aquinas (temperance, justice, prudence, and courage), based on
neurobiological evidence of potential for moral enhancement and
viii Preface
psychotherapeutic relevance [13]. The virtues highlighted include
those of self- control (accountability, humility, and equanimity), be-
nevolence (forgiveness, compassion, and love), intelligence (defi-
ance and phronesis, or practical wisdom), and positivity (gratitude,
self- transcendence, and hope). A concluding chapter considers the
implications for psychiatry of the emerging science of human flour-
ishing. Our aim is to give readers a fuller appreciation of the impor-
tance of virtue in the therapeutic encounter, a clearer understanding
of clinical indications for focusing on particular virtues, and enhanced
practical ways of promoting human growth.
References
1. Michel AA. Psychiatry after virtue: A modern practice in the ruins. J Med
Philos. 2011;36:170– 186.
2. Peterson C, Seligman MEP. Character Strengths and Virtues: A Handbook
and Classification. New York: Oxford University Press; 2004.
3. Robertson M, Walter G. Overview of psychiatric ethics II: virtue ethics
and the ethics of care. Australas Psychiatry. 2007;15:201– 206.
4. Pellegrino ED, Thomasma CD. The Virtues in Medical Practice.
New York: Oxford University Press; 1993.
5. Radden J, Sadler J. The Virtuous Psychiatrist: Character Ethics in Psychiatric
Practice. New York: Oxford University Press; 2010.
6. Waring D. The Healing Virtues: Character Ethics in Psychotherapy.
New York: Oxford University Press; 2016.
7. Woolfolk RL. Virtue and psychotherapy. Philos Psychiatry Psychol.
2012;19:41– 43.
8. Martin MW. Psychotherapy as cultivating character. PPP. 2012;19:37– 39.
9. Bergin AE. Psychotherapy and religious values. J Consult Clin Psychol.
1980;48:95– 105.
10. Kinghorn W. The politics of virtue: An Aristotelian-Th omistic engage-
ment with the VIA classification of character strengths. J Pos Psychol.
2017;12:436– 446.
11. Roberts RC. Virtues and belief in God. J Pos Psychol. 2017;12:480– 488.
12. Peteet JR. What is the place of clinicians’ religious or spiritual
commitments in psychotherapy? A virtues based perspective. J Relig
Health. 2014;53:1190– 1198.
13. Hughes JJ. Moral enhancement requires multiple virtues: Toward a
posthuman model of character development. Cambridge Q Healthc Ethics.
2015;24:86– 95.
Contributors
C. Robert Cloninger Warren Kinghorn
Professor Emeritus of Psychiatry Associate Professor of Psychiatry
Washington University School of Department of Psychiatry and
Medicine Behavioral Sciences
Department of Psychiatry Duke University
St. Louis, MO, USA Durham, NC, USA
Director of Institute for Research
Jerome Kroll
Anthropedia Foundation
Professor of Psychiatry Emeritus
St. Louis, MO, USA
Department of Psychiatry
Kevien M. Cloninger University of Minnesota
Executive Director Medical School
Anthropedia Foundation Minneapolis, MN, USA
St. Louis, MO, USA
Perry C. Mason
Nicholas D. Covaleski Professor Emeritus
PhD Student Department of Philosophy
Department of Religion Carleton College
Boston University Northfield, MN, USA
Boston, MA, USA
John R. Peteet
Paul Gilbert Associate Professor
Professor of Clinical Psychology Department of Psychiatry
Centre for Compassion Research and Harvard Medical School
Training Boston, MA, USA
University of Derby
Nancy Nyquist Potter
Derby, UK
Professor of Philosophy emerita and
Lilian Jans- Beken Adjunct
Senior Researcher Department of Psychiatry and
The Thriving Human Behavioral Sciences
Science Center University of Louisville
Venray, The Netherlands Louisville, KY, USA
Senior Editor of Philosophy,
Psychiatry, and Psychology