Social justice in counseling psychology practice: Actualizing the ethics of compassion

Abstract

This article articulates how compassion can be integrated into counseling psychology practice to augment the commitment to social justice. Drawing on a humanistic–existential paradigm that asserts the primacy of ethics, a multilayered understanding of compassion is explored in its implication for practitioners. First, as acknowledgment of the other’s suffering, compassion means being aware of the relational dynamics that extends from the therapist–client dyad to include the wider communities to which they belong. Second, as appreciation for suffering as an existential given, compassion expresses connectedness through the shared experience of otherness while revealing the inherent potential toward growth in clients. Third, as access to the suffering other, compassion exposes the societal power dynamics that threaten the therapeutic relationship. Fourth, as acceptance of the response to the suffering other, compassion requires to embrace the intrapersonal and interpersonal experience evoked in meeting clients. Fifth, as alleviation of the other’s suffering, compassion becomes the expression of a value-based practice that can drive the shift that sees psychotherapy as an interpersonal process based on connectedness to foster healing. Therefore, compassion is put forward as the foundation of counseling psychology ethics of social justice.

Introduction

One of the standards for practitioner psychologists is the ability to practice in a nondiscriminatory manner (Health and Care Professions Council [HCPC], 2015). Although this standard extends to psychological practice, counseling psychology in the United Kingdom arose with a distinctive commitment to social justice, translated into an epistemological flexibility to understand otherness (Milton, 2011). Accordingly, from a social-constructivist perspective (Cottone, 2004), counseling psychologists are called to be reflective practitioners (Donati, 2016) and draw on a plurality of empirical and psychological paradigms to make meaning of their clients’ experiences, thus being aware of underlying assumptions (Campbell-Balcom & Martin-Berg, 2019). This axiological awareness highlights the endeavor to develop antioppressive practice by challenging existing power dynamics that maintain social inequalities (Strawbridge, 1994). Although counseling psychology practice is not immune to cultural, societal, historical, and economic forces (Strawbridge, 1994), its humanistic value base involves the appreciation of the context in which the person is embedded to understand the social origins of mental illness (Vermes, 2017) and expose how power might operate within society, perpetuating discrimination (Johnstone & Boyle, 2018). Specifically, Cooper (2009) finds the core of counseling psychology humanistic ethic in Levinas’ (1961/1979) conceptualization of welcoming the other in their infinite otherness, which attests their inherent unknowability. Therefore, counseling psychology requires practitioners to advocate an understanding of otherness that transcends objectification (Cooper, 2009) and demands equity as recognition of individuals’ different needs against the silence of marginalization (Qureshi & Collazos, 2011).

Welcoming the other means acknowledging their suffering, which calls for a response (Levinas, 1961/1979). Resonating with the centrality of the therapeutic relationship in counseling psychology, compassion offers an intersubjective understanding of suffering, encompassing both the relationship with oneself and the relationship between oneself and otherness (Strauss et al., 2016). For Levinas (1982/2002), compassion is the supreme ethical principle as the witnessing of the other’s suffering and the “response-ability” to alleviate it. Consonantly, a review of the literature (Strauss et al., 2016) pinpoints the distinctive elements comprising compassion, namely: the acknowledgement of the other’s suffering; the appreciation of suffering as existential given; the access to the suffering other; the acceptance of the response to the suffering other; the alleviation of the other’s suffering. Consequently, if counseling psychology is ethics in action (Cooper, 2009), as a multilayered unfolding process, compassion arguably encapsulates practitioners’ commitment to respond to the other’s suffering, by emphasizing how their humanistic value base can be catalyst for change to inform a reflective antioppressive and antidiscriminatory practice (Campbell-Balcom & Martin-Berg, 2019; Sarantakis, 2017).

Building on the understanding of ethics as compassionate response-ability to the suffering other (Levinas, 1961/1979), I will consider some of the challenges and opportunities to uphold counseling psychology practice as an ethical endeavor (Cooper, 2009) by exploring the polysemantic definition of compassion in the context of sociological, cultural and critical perspectives. Specifically, I will draw from my experience of working with a group of clients who exposed me to their human diversity and called for my response-ability to their suffering. Given the attention in counseling psychology to the person of the therapist (Sleater & Scheiner, 2020), I will also consider how my sociocultural and political context has informed my antidiscriminatory and antioppressive practice. Therefore, I will propose compassion as a fundamental ethical principle that appeals to counseling psychologists to contribute to social justice.

Compassion as Acknowledgment of the Other’s Suffering

As an act of bearing witness to the other’s suffering, compassion requires a shift to an interpersonal understanding of suffering that embraces the “world dimension” (Spinelli, 2002, p. 118) within the therapeutic relationship. Accordingly, practitioners are called to explore their clients’ experience of their interrelatedness with others and how the wider system responds to the clients’ way of being (Milton, 2018). During one of my placements as part of my training, I was based in a community with a high percentage of immigrants who had been historically associated with the stigma of poor socioeconomic conditions and deprivation. Young people were referred as part of an initiative to tackle antisocial and offending behavior. Hence, prior to my first sessions, I had already been exposed to a multitude of cultural and sociological assumptions that could interfere with my ability to meet my clients as unique persons. For instance, migration and poverty can increase vulnerability to mental illness thereby decreasing accessibility to support services, revealing a power imbalance wherein marginalization prevents the development of connectedness (Bhugra & Becker, 2005). Moreover, the definition of antisocial and offending behavior varies according to cultural norms that may portray the same behavior as tolerable or condemnable (Millie, 2008) depending on societal expectations set by the dominant group to maintain the unequal distribution of power (Qureshi & Collazos, 2011). A compassionate lens would contextualize individuals’ difficulties considering the impact of adverse community environments, such as poverty, community disruption, poor housing qualities, and discrimination, on these young people’s difficulties (Ellis & Dietz, 2017), thus calling for an antidiscriminatory practice. Hence, compassion asks practitioners to commit to reducing suffering in the system they inhabit beyond the confines of the therapy room, reporting the structural inequalities that contaminate communities.

My challenge was to make sense of my clients’ suffering beyond the stigmatization imposed on them while reflecting on my response to their diversity (Moane, 2008). Working through a socioeconomic condition that had eventually allowed me to overcome disparities and access postgraduate education as opposed to the lack of opportunities experienced by my clients, I was sensitive to the power differential in my practice (Fung & Lo, 2017). As power relationships belong to the political arena (Strawbridge, 1994), I had to maintain ethical awareness of the potential to be perceived as oppressive by advocating societal values that were functional to the maintenance of my clients’ exclusion. To empower my clients, my responsibility was to help them acknowledge their suffering beyond a justification–suppression model that would legitimize acting on assumptions instead of unveiling the connection between their difficulties and social conditions (Crandall & Eshleman, 2003). Without the awareness of context and the meaning of being marginalized, the other risks becoming an abstraction that reflects the practitioner’s ideal of being the helper without seeing clients in the realness of their existence. Compassion implies the idea of communion with the other seen within the societal and historical context of relationships from which their individuality has emerged. Accordingly, as willingness to acknowledge the circumstances for the other’s suffering, compassion can inform antioppressive practice by valuing clients’ experiential expertise and enhancing their sense of agency (British Psychological Society [BPS], 2018).

Consequently, compassion resonates with counseling psychologists’ endeavor to acknowledge both clients and practitioners as persons embedded in a network of relationships. By integrating compassion into their practice, practitioners ought to seek their own education around the multilayered systems of oppression affecting the specific populations with which they work. Without such understanding, practitioners risk diminishing the experience of suffering, lacking the idiographic appreciation of clients (Johnstone & Boyle, 2018). Compassion demands an awareness of the political, cultural, socioeconomic contexts which inform the “response-ability” to the embodied other pragmatically, through continuing professional and personal development (Sarantakis, 2017). Beyond the therapy room, compassion fuels a commitment to uncover oppression so that practitioners can articulate how their practice can be an expression of social justice instead of maintaining the status quo (Palmer & Parish, 2008). Accordingly, suffering emerges from clients’ relational context transcending the intrapersonal dimension that leads to objectification. Therefore, by extending the exploration of suffering to the clients’ environment, compassion can promote a socially just practice calling for practitioners’ personal and social responsibility.

Compassion as Appreciation for Suffering as an Existential Given

Compassion reveals suffering as an existential challenge that emerges from the person’s dynamic relationship with their context (Langle, 2008; Sullivan, 2016). As the system had already defined my clients as antisocial and offending, the risk for my practice to become oppressive resided in depriving them of a shared humanity (Vaes et al., 2012). Akin to my clients’ experience of diversity, being from a multiethnic background growing up in a predominantly monoethnic community, I had experienced exclusion from the dominant group. This separateness made me sensitive to uncovering both visible and invisible dimensions of human diversity, while exploring the meaning of my otherness. Whereas my clients seemed to be defying the system, thus being ostracized, I strove to understand the system, thus expressing my need for belongingness. Despite the idiosyncrasy of our responses in relation to marginalization, my clients and I shared the existential experience of suffering (Langle, 2008). Thus, by revealing our shared humanity, compassion provided me with the opportunity to connect with my clients through my experience of otherness as an existential touchstone (Tangen & Cashwell, 2016).

Nevertheless, my otherness had the potential to become oppressive. In my trainee role, I risked reinforcing a hierarchical distribution of power by focusing on a deficit model that sees clients as lacking and defective. As an alternative, compassion can be framed within an “appreciative inquiry” that appeals to practitioners’ responsibility to enhance the positive aspects and strengths that promote clients’ well-being (Quinney & Richardson, 2014). In hindsight, I could have resorted to supervision to explore how my diversity might have been perceived by my clients and the system, using, if appropriate, self-disclosure to foster the therapeutic alliance. Although the lack of awareness of how both my clients and I were affected by societal mechanisms of discrimination left the potential for antioppressive practice unfulfilled, a self-compassionate stance can infuse my practice with humility (Hook et al., 2017) and curiosity of the unknown (Lakeman, 2014). Intrapersonally, by learning from my clients’ experiences of otherness, I can engage in a reflexive process to acknowledge my limitations as potential for personal and professional development (Donati, 2016). Interpersonally, by validating my clients’ otherness as transcending my assumptions, I can acknowledge each therapeutic relationship as an intercultural encounter (Qureshi & Collazos, 2011) which requires my willingness to be surprised by the other. Accordingly, while overcoming the risk of oppressive practice in the reduction of otherness to sameness (Levinas, 1961/1979), compassion attests how relatedness implies the commitment to respect the other (Cooper, 2009).

Consequently, compassion is the turning of the attention toward the other involving a sense of morality as respect for their suffering (Bell, 1998). Although the other remains inherently unknowable, compassion illuminates suffering by subverting power dynamics that want to erase otherness. In order to identify implicit assumptions, values, privilege, and biases that prevent them from engaging effectively with marginalized populations, practitioners ought to engage in their own antioppression work. Education, training, peer support, supervision, personal therapy, self-reflection, and outreach can all become avenues wherein complexities and responsiveness can be discussed to address the multidimensional interaction among systems and how they influence assumptions or prejudice (Hays, 2016). Thus, compassion translates into practitioners’ commitment to understanding the potential for oppression inherent in holding power by exploring the template of their self-identity, getting a working distance from beliefs that can be reevaluated, and being open to change through the meeting with the other (Palmer & Parish, 2008). Therefore, by exposing the vulnerability to otherness, compassion allows the expression of practitioners’ humanity in their response-ability to the suffering other (Edelglass, 2006).

Compassion as Access to the Suffering Other

By revealing the other as suffering, compassion calls for a relationship of radical openness to the mystery of otherness. As suffering is an existential wound, compassion expresses the vulnerability to the other whose call cannot be unheard (Levinas, 1982/2002). Consonantly, my vulnerability to my clients’ suffering called for my emotional resonance to foster action (Strauss et al., 2016). Exploring my clients’ perspectives involved adjusting my practice to different degrees of intervention depending on the young people’s preferences (Cooper & Norcross, 2016). As counseling psychology endorses the individualization of therapy within a pluralistic framework (McAteer, 2010), my practice could have run the risk of being unconsciously oppressive (Lago, 2011) if I had not remained open to alternative conceptualizations of self, individual, and therapeutic relationship (Strawbridge, 1994). Accordingly, a compassionate framework appeals to clinicians to advance therapeutic pluralism to increase the possibility of helping. Specifically, compassion demands the development of a potentiality model that integrates clients’ resources into a dimensional understanding of mental health difficulties (Raskin, 2019). As an example, I had to be mindful of working within my competence (BPS, 2018) and utilize supervision to avoid additional suffering by imposing the therapeutic approach within which I was most familiar as the only possibility to support my clients. Furthermore, accessing clients’ suffering means exploring their internal and external world so that “compassionate decision-making” can arise from practitioners’ awareness to select the most appropriate course of actions to improve clients’ welfare and target the commissioning of services. Consequently, compassion involves practitioners’ ability to transcend their own perspective to embrace the other’s suffering and simultaneously make interventions effective in real-world settings that can benefit the other.

Albeit my therapy sessions provided an opportunity to promote interconnectedness by exploring my clients’ difficulties, the risk for my practice to become discriminatory manifested in my approach to my clients’ suffering. Despite similar presenting concerns (e.g., anger, behavioral, and emotional dysregulation), I had to avoid mistaking a standardized intervention with sameness, thus translating diversity into discrimination and neglecting the principle of equity (Thompson, 2016). Conversely, by tailoring my interventions to their idiosyncratic needs, I held my clients’ shared experience of suffering while appreciating the uniqueness of their difficulties. For instance, despite similar behavioral problems, my sessions uncovered the young people’s idiosyncratic backgrounds, such as bereavement, family breakdowns, or parentification, in addition to belonging to a minority within a minority due to their ethnicity or disability, leading to multiple stressors (Stienstra & Nyerere, 2016). Furthermore, I could express my power within the system by asserting how my role would not perpetuate a simplified understanding of antisocial behavior that discounted individual differences (Millie, 2008). Thus, developing an antidiscriminatory practice through a compassionate stance means building a therapeutic relationship by valuing the intersectionality of clients’ multiple identities that make them vulnerable to marginalization (Crenshaw, 2005).

Consequently, by calling for a response that challenges marginalization and oppression, compassion urges practitioners to defy the legitimization of a bystander’s behavior. Specifically, compassion calls for action through the ongoing endeavor to reduce suffering by recognizing how multiple layers of oppression are interwoven to create a distinctive experience of injustice that is greater than the sum of its parts (Crenshaw, 2005). In addition to understanding the suffering of the oppressed groups to which individuals belong, compassion demands interventions that target the idiosyncratic manifestation of oppression experienced by the individual resulting from the unique melding of the negative operations of power in intersectionality (Crenshaw, 2005; Johnstone & Boyle, 2018). While acknowledging the existential dimension of suffering, compassion questions those actions that lead to the other’s suffering. Therefore, compassion appeals to practitioners’ power to denounce suffering as injustice.

Compassion as Acceptance of the Response to the Suffering Other

Even though facing the suffering other can evoke difficult feelings due to their unjust conditions, compassion is the ability to accept this emotional response as part of the relational experience with oneself and otherness (Gilbert, 2009). Working with marginalized young people evoked my powerlessness and a range of negative feelings, such as anger, resentment, frustration, and sadness. For instance, I had to admit my limitations as a trainee (Strawbridge, 1994) as I could not change one of my client’s precarious circumstances after their parents’ divorce. Despite my powerlessness in the wider system, I could empower my client to express their needs and make sense of the changing nature of their relationships. Thus, developing an antioppressive practice meant exploring how I could make my response to my clients’ suffering a deliberate choice to promote social justice and the therapeutic alliance (Ali et al., 2008).

Resonating with the reflective practitioner model (Donati, 2016), compassion can foster emotional reflexivity (Burkitt, 2012; Holmes, 2010) by examining the emotional reactions to the suffering other, thus advocating antidiscriminatory and anti-oppressive practice (Cropanzano et al., 2011; King, 2007). As referrals mentioned my clients’ emotional problems without providing any context, my supervisor helped me contemplate the social identity perspective from which the system seemed to be looking at otherness as out-group by denying their diversity instead of exploring what had happened to them (Harper & Cromby, 2020). On a collective level, by avoiding pathological labelling, compassion resonates with a paradigm shift from an intrapersonal perspective that focuses on symptoms to a social–intrapersonal perspective that addresses suffering as collective responsibility (Harper & Cromby, 2020). As an example, despite the fact that a client had been referred for bullying behavior, my sessions uncovered a series of bereavements in my client’s life. Accordingly, we could work on exploring how the system could best support this young person through the normalization of their anger as part of their grieving process. By contextualizing the impact of suffering on clients, compassion can uncover a sanist discourse that equates psychotherapeutic interventions to oppression without acknowledging individuals’ circumstances (Morrow & Weisser, 2012). Accordingly, compassion calls for a transition from a “pathology model” that focuses on problems to a “potentiality model” to promote social justice.

Consequently, compassion encourages practitioners to explore emotional, behavioral, and cognitive responses to clients (Strauss et al., 2016), while tolerating reactions that might interfere with the development of a therapeutic alliance. Therefore, compassion requires practitioners’ sense of morality (Nussbaum, 1996) to arise from the breach of equity thus drawing on suffering to promote social justice (Brewis, 2017).

Compassion as Alleviation of the Other’s Suffering

Resonating with counseling psychology practice as ethics in action (Cooper, 2009), compassion involves practitioners’ active engagement to reduce the other’s suffering. Furthermore, as suffering can be understood in a relational framework wherein the other’s call remained unanswered (Levinas, 1982/2002), compassion enters the political realm by acting on the confirmation of otherness to provide a response that can restore social justice (Whitebrook, 2002). As I was working with young people who had experienced marginalization due to their behavioral presentation, I aimed to counteract the oppressiveness of the system without colluding with my clients or the system, fueling their oppositional relationship. For instance, one client had resorted to offending behaviors to protect their younger siblings as a result of exposure to poverty. Exploring the underlying systemic issues allowed us to address my client’s shame, which opened the opportunity to access the available support. As a further example, one of my clients had chronic pain that impaired their mobility, which required adjustments to the service to facilitate its accessibility (Kanellaki & Kanellakis, 2009). Thus, compassion emphasizes how antidiscriminatory practice has pragmatic implications that call for practitioners’ active engagement.

Furthermore, my commitment to alleviate my clients’ suffering urged me to reflect on my privilege within the system. As the adults in my clients’ life could make decisions to determine their academic progression, family arrangements, or disciplinary actions, I had the opportunity to exert the power inherent in my role of working with young people by pursuing a social justice agenda as a commitment to empowerment (Cutts, 2013). For instance, some young people were ambivalent regarding the value of their active role in engaging in therapy. Instead of pathologizing, I strove to facilitate the expression of my clients’ potential in line with a humanistic framework (Strawbridge, 1994). Simultaneously, I had to ensure my clients’ readiness for therapy by evaluating their choice to engage (HCPC, 2016). Accordingly, my commitment to alleviate my clients’ suffering started with the validation of their decision-making and the consideration of the power dynamics inherent in the system they inhabited (HCPC, 2016). Hence, compassion as alleviation of suffering means empowering clients while developing a shared understanding of their difficulties that accounts for their resources and resilience.

Consequently, compassion emphasizes how a value-based practice extends to collective wellness (Prilleltensky, 2001) and appeals to practitioners to respond to otherness on an individual and community level. Through compassion, practitioners have the obligation to expand their commitment to social justice through systems level advocacy. Practicing compassion means being able to meet clients’ ever-evolving needs by seeking opportunities to empower them. By taking actions to reduce collusion with oppression, practitioners ought to create a sociopolitical agenda that actively pursues the objective of abolishing barriers and establishing systems of inclusion and well-being promotion (Kennedy & Arthur, 2014). Furthermore, compassion in psychotherapeutic practice advocates an intersectional social justice framework of mental health which recognizes the potential of interventions to alleviate clients’ multiple exposures to oppression (Morrow & Weisser, 2012). Therefore, by underpinning ethics of care (Fotaki, 2015), compassion can be the foundation of counseling psychology as commitment to a socially just practice that fosters the synergetic potential for human flourishing (Cooper, 2016; Williams, 2008).

Compassion as Foundation of Counseling Psychology Ethics of Social Justice

To summarize, as a relational–humanistic profession, counseling psychology has the challenge to welcome the other, thus promoting a restorative practice as antithesis of discrimination and oppression. Consonantly, compassion enshrines counseling psychologists’ commitment to antidiscriminatory and antioppressive practice as ethical enterprise. First, by acknowledging the other’s suffering, compassion encourages practitioners to consider the interpersonal sphere, contextualizing clients’ suffering within the power dynamics that underpins society and maintain marginalization. Second, by appreciating the existential dimension of suffering, compassion urges practitioners to withstand the justification of oppression while fostering interconnectedness. Third, by accessing the suffering other, compassion exposes practitioners’ vulnerability to the other’s call as the opportunity to be response-able in the awe-inspiring meeting with otherness. Fourth, by accepting the response to the suffering other, compassion requires practitioners to resort to their reflexivity to inform their practice as deliberately oriented to inclusiveness. Finally, by alleviating the other’s suffering, compassion is practitioners’ commitment to human flourishing as an expression of their ethics of care for individuals and their communities. Therefore, I put forward compassion as a guiding principle for practitioners to fulfil the potential for counseling psychology practice as ethics-in-action to become ethics-in-actualization of social justice.